Dynamic change of high-risk plaque detected by coronary computed tomographic angiography in patients with subclinical coronary artery disease

We studied the dynamic change of high-risk plaque detected by coronary computed tomographic angiography (CCTA) in patients with subclinical coronary artery disease. We analyzed paired CCTA findings in 103 patients. The follow-up period was 1.37 ± 0.49 years. We studied the prevalence and change of high-risk plaque (HRP) defined as positive remodeling, low attenuation plaque, spotty calcification, or napkin-ring sign. Of 413 plaques detected by CCTA, thirty-seven patients had 47 HRP at baseline. At follow-up, eight patients showed disappearance of HRP. Sixty-six patients had no HRP at baseline. At follow-up, new HRP was detected in 12 patients. As a whole, 20 patients (19.4 %) showed appearance or disappearance of HRP. For 29 patients with persistent HRP, five of twenty-one patients with one HRP at baseline showed two HRP at follow-up. Five of eight patients with two HRP at baseline showed one HRP at follow-up. As a whole, in 27 % of patients with persistent HRP, the number of HRP changed. These changes were neither associated with statin use nor location of the HRP. Our results showed that about 20 % of patients showed appearance or disappearance of HRP 1 year later. In addition, in 27 % of patients with persistent HRP, the number of HRP increased or decreased. These results suggest a dynamic nature of HRP.