Emerging Concepts in CT-Guided Treatment of Coronary Artery Disease

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In a recent interview, Amir Ahmadi, M.D., discussed limitations of conventional diagnostic assessments for people with suspected coronary artery disease, and the emergence of AI-enabled plaque quantification to facilitate more timely detection and intervention.

Conventional assessments for possible coronary artery disease based on presenting symptoms and/or risk profiles are inadequate, according to Amir Ahmadi, M.D.

In a recent interview, Dr. Ahmadi noted key research findings —presented at the European Congress of Cardiology in 2024 and currently being evaluated for a peer-reviewed publication — that showed that 67 percent of patients under 65 with a first heart attack had no pain two days prior, 54 percent had no pain until the day of the heart attack, and 47 percent of patients wouldn’t have met criteria for statin initiation two days prior to a heart attack.

“Coronary disease is a plaque in the heart. … We do everything about risk stratification by measuring the LDL (low-density lipoprotein) in the bloodstream, not the heart vessels. Now plaque quantification and looking at a CT can actually tell us … about the quantification of what actually matters at the level of the heart vessel, and that's game changing in my opinion,” emphasized Dr. Ahmadi, an associate professor of medicine and cardiology, and director of inpatient cardiology at the Mount Sinai Fuster Heart Hospital in New York City.

Dr. Ahmadi said use of the AI-powered software PlaqueIQ (Elucid) with computed tomography angiography (CTA) facilitates a shift from “risk factor guesstimation to treating the disease itself.” Not only does PlaqueIQ bolster accuracy with initial assessments, it enables monitoring of treatment as well, according to Dr. Ahmadi, who will be presenting on CT-guided treatment of CAD at the Society of Cardiovascular Computed Tomography (SCCT) conference in Montreal, Canada.

“What you need is an accurate, objective and reproducible measurement of different types of plaque, and specifically the types of plaque that are known to make the person and the lesion more prone to have a plaque rupture and heart attack,” maintained Dr. Ahmadi, the lead scientific advisor for Elucid.

(Editor’s note: For related content, see “Can Emerging AI Software Offer Detection of CAD on CCTA on Par with Radiologists?,” “Study Shows Enhanced Diagnosis of Coronary Artery Stenosis with Photon-Counting CTA” and “Meta-Analysis Shows Merits of AI with CTA Detection of Coronary Artery Stenosis and Calcified Plaque.”)

For more insights from Dr. Ahmadi, watch the video below.

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