Noninvasive Assessment of Coronary Plaque Burden Using Multislice Computed Tomography

We performed coronary plaque imaging with 16-row multislice computed tomography in 85 patients who had stable angina pectoris and a high pretest likelihood of having coronary plaque to evaluate plaque burden, i.e., extent (number of diseased coronary segments) and size (small vs large) of plaque. We also assessed type of plaque (calcified, noncalcified, or mixed) and its anatomic distribution. Of 85 patients included, 78 (92%) had fully evaluable multislice computed tomograms that allowed assessment of coronary plaque burden, including major and side branches (≥2 mm), yielding a total of 855 segments. These 78 patients (92% men; mean age ± SD 58 ± 11.5 years) were in sinus rhythm, with heart rates of <70 beats/min (spontaneous or induced by β blocker). Plaque was detected in 57% of all segments (487 of 855). The mean number of segments with plaque per patient ± SD was 6.2 ± 3.9. Plaque was classified as large in 33% of segments and small in 67%. Overall, 65% of plaques were calcified, 24% were noncalcified, and 11% were mixed. Plaques were predominantly located in the proximal and middle segments of the main coronary vessels.