Emerging quantitative CCTA imaging biomarkers for cardiovascular risk stratification: a narrative review.
Hepatic steatosis on CT linked to higher odds of cardiovascular events in meta-analysis
Emerging quantitative CCTA imaging biomarkers for cardiovascular risk stratification: a narrative review.
Cardiac computed tomography angiography (cardiac computed tomography angiography) has evolved beyond anatomical stenosis assessment into a comprehensive platform for cardiovascular and cardiometabolic risk stratification.
In this narrative review, we synthesize current imaging biomarkers, evaluate their individual and combined prognostic value, and propose a conceptual multimarker framework for cardiovascular risk stratification-recognizing that several domains remain investigational and are not yet ready for routine, biomarker-guided management.
Epicardial adipose tissue volume and density independently predict incident coronary heart disease, atrial fibrillation, and all-cause mortality across large prospective cohorts.
Quantitative plaque analysis identifies high-risk features - including low-attenuation plaque, positive remodeling, and napkin-ring sign - that independently predict major adverse cardiovascular events (major adverse cardiovascular events) beyond stenosis severity.
FFR-CT carries a Class 2a guideline recommendation for intermediate lesions and demonstrates superior vessel-level diagnostic accuracy compared with SPECT and comparable performance to PET in head-to-head trials.
Cardiac computed tomography angiography provides a pragmatic, multidimensional framework that integrates anatomic, functional, inflammatory, and metabolic information from a single noninvasive examination.
While standardization, longitudinal validation, and equitable representation in research cohorts remain unresolved challenges, ongoing advances in AI-driven image analysis and multiomics integration may, if validated in prospective outcome studies, support the future translation of quantitative cardiac computed tomography angiography imaging biomarkers into more personalized cardiovascular care.