Coronary plaque burden and computed tomography-derived fractional flow reserve are predictors of 5-year…

Cohort studyJournal of vascular surgery cases and innovative techniques· Oct 2026

Coronary plaque burden and computed tomography-derived fractional flow reserve are predictors of 5-year mortality in peripheral artery disease patients with no known coronary artery disease.

Dainis Krievins, Sanda Jegere, Frank Arko … Christopher K Zarins

RadiologyCohort studyPrognosis

High coronary plaque burden linked to nearly 4-fold higher 5-year death risk in peripheral artery disease

Coronary plaque burden and computed tomography-derived fractional flow reserve are predictors of 5-year mortality in peripheral artery disease patients with no known coronary artery disease.

Dainis Krievins … Christopher K Zarins

Journal of vascular surgery cases and innovative techniques · Oct 2026

Purpose

This study assessed the value of CT-QPA and FFR CT in predicting 5-year mortality in patients with vascular surgery with no known coronary artery disease.

Methods

With peripheral artery disease with no evidence of coronary artery disease who were cleared for elective peripheral vascular surgery were enrolled in a prospective study of preoperative computed tomography angiography and FFR CT to evaluate cardiac risk.

n = 124 patients

Results

high plaque burden nearly quadruples 5-year death risk

HR 3.60 (95% CI 1.60 to 7.90)

null 1

1.60

7.90

CI excludes the null - significant

More results

Among 124 patients with peripheral artery disease with no cardiac history or symptoms (mean age, 67 ± 8 years; 76% men), coronary plaque burden was high (median [total plaque volume] 550 mm 3 [IQR, 299-1156]), and 53% had asymptomatic (silent) coronary ischemia (FFR CT ≤ 0.80).

More results

Nonsurvivors had nearly twofold higher total plaque volume compared with survivors (975 vs 458 mm 3 ; P < .001), with significant increases in calcified ( P < .001), noncalcified ( P < .001), and low-attenuation plaque ( P = .038).

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Conclusion · 1 of 2

In patients with peripheral artery disease with no known coronary artery disease undergoing elective vascular surgery, coronary plaque burden and silent coronary ischemia detected by CT-QPA and FFR CT were predictors of a 5-year mortality.

Conclusion · 2 of 2

Coronary computed tomography angiography with quantitative plaque and FFR analysis should be considered for comprehensive cardiac risk stratification in patients with vascular surgery, regardless of cardiac symptoms.

Coronary plaque burden and computed tomography-derived fractional flow reserve are predictors of 5-year mortality in peripheral artery disease patients with no known coronary artery disease.

Coronary plaque burden and computed tomography-derived fractional flow reserve are predictors of 5-year mortality in peripheral artery disease patients with no known coronary artery disease.

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