Association of high-risk CT coronary artery plaque features with major adverse cardiovascular events: a prespecified secondary analysis of the DISCHARGE trial
Question Do high-risk plaque (HRP) features on coronary CT have incremental prognostic value after adjustment for cardiovascular risk factors in stable chest pain? Findings A combined definition of HRP features on coronary CT was independently associated with major adverse cardiovascular events, with similar prognostic value to obstructive coronary artery disease after risk adjustment. Clinical relevance HRP features, including a coronary artery calcium score ≥ 400 Agatston units or traditional high-risk plaque characteristics on coronary CT, provide incremental prognostic value in predicting MACE in stable chest pain patients, offering a potential tool for improved risk stratification and management.
Authors
- Gershan Davis (ORCID: https://orcid.org/0000-0001-9096-5495)
- Matthias Rief (ORCID: https://orcid.org/0000-0002-5298-1969)
- Ainhoa Peralta Rubio
- Melanie Estrella (ORCID: https://orcid.org/0000-0003-1847-7870)
- Nada Čemerlić Ađić (ORCID: https://orcid.org/0009-0005-5186-0072)
- Ioana Rodean
- Thomas Fritz Hansen
- Henryk Dreger (ORCID: https://orcid.org/0000-0003-1909-4329)
- Tem Jørgensen
- Kristian Schultz Hansen (ORCID: https://orcid.org/0000-0003-2976-4947)
- Nina Rieckmann
- Radosav Vidaković (ORCID: https://orcid.org/0000-0001-9113-8467)
- Niall Mulvihill
- Viktoria Wieske (ORCID: https://orcid.org/0000-0003-3847-9419)
- Christine Kubiak (ORCID: https://orcid.org/0000-0002-1505-8622)
- Stephen Schröder (ORCID: https://orcid.org/0009-0008-3709-3585)
- Vojtěch Suchánek (ORCID: https://orcid.org/0000-0003-0668-221X)
- Federico Biavati (ORCID: https://orcid.org/0000-0002-3558-3408)
- Dewey Marc
- Stephanie Kelly (ORCID: https://orcid.org/0000-0002-6874-5055)
- Filippa Valente
- C. Delles
- ROXANA HODAS
- Mahmoud Mohamed (ORCID: https://orcid.org/0000-0002-3077-5427)
- M Péter
- Mariusz Kruk
- Maria Bosserdt
- Alberto Boi
- M Francone
- M Fisher
- R Faria
- A N Neskovic
- P Donnelly
- T Benedek
- K F Kofoed
- Borbála Vattay
- Jonathan D. Dodd
- Cyril Štěchovský
- Andrejs Erglis
- Rosca Aurelian
- Konrad Neumann
- José F. Rodriguez-Palomares
- Donata Kuśmierz
- Vasco Gama Ribeiro
- Helena Domínguez Vall-Lamora
- Antanas Jankauskas
- Colin Berry
- Sarah Feger
- Gudrun Maria Feuchtner
- Robert Haase
- Erica Thwaite
- Charlotte Sørum
- Béla Merkely
- Pal Maurovich-Horvat
- Jacqueline Müller-Nordhorn
- Balazs Ruzsics
- Małgorzata Ilnicka-Suckiel
- Ignacio Diez
- Adriane Elisabeth Napp
- Tanja Drosch
- Michael Woinke
- Filip Ađić
- Elke Zimmermann
- Michelle C. Williams
- Cezary Kepka
- Clare Orr
- Fabian Plank
- Luca Saba
- Ligita Zvaigzne
- Bruno García del Blanco
- Melinda Boussoussou
- Juhani Knuuti
- Matthias Gutberlet
Institutions
- University College Dublin (IE)
- Semmelweis University (HU)
- Universitat Autònoma de Barcelona (ES)
- University of Copenhagen (DK)
- Lithuanian University of Health Sciences (LT)
- Humanitas University (IT)
- Innsbruck Medical University (AT)
- University of Liverpool (GB)
- University of Turku (FI)
- Edge Hill University (GB)
- University of Novi Sad (RS)
- University of Cagliari (IT)
- Amager Hospital (DK)
- Frederiksberg Hospital (DK)
- Hvidovre Hospital (DK)
- Turku University Hospital (FI)
- Golden Jubilee National Hospital (GB)
- Hospital of Lithuanian University of Health Sciences Kaunas Clinics (LT)
- Copenhagen University Hospital (DK)
- Gentofte Hospital (DK)
- Royal Liverpool University Hospital (GB)
- Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș (RO)
- British Heart Foundation (GB)
- Humboldt-Universität zu Berlin (DE)
- University of Belgrade (RS)
- Liverpool Heart and Chest Hospital (GB)
- Aintree University Hospital (GB)
- Hospital de Basurto (ES)
- Universitätsklinikum Tübingen (DE)
- University Hospital in Motol (CZ)
- Pauls Stradiņš Clinical University Hospital (LV)
- Alb Fils Kliniken (DE)
- Vall d'Hebron Institut de Recerca (ES)
- Turku PET Centre (FI)
- Deutsches Herzzentrum der Charité (DE)
- Centro de Investigación Biomédica en Red (ES)
- St. Vincent's University Hospital (IE)
- Leipzig Heart Institute (DE)
- Institute for Cardiovascular Diseases of Vojvodina (RS)
- Varsinais-Suomen Sairaanhoitopiiri (FI)
- German Centre for Cardiovascular Research (DE)
- Institute of Cardiology (PL)
- Zemun Hospital (RS)
- Centro Hospitalar de Vila Nova de Gaia (PT)
- European Clinical Research Infrastructure Network (FR)
- IRCCS Humanitas Research Hospital (IT)
- South Eastern Health and Social Care Trust (GB)
- Azienda Ospedaliera G. Brotzu (IT)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
- University of Glasgow (GB)
- Sapienza University of Rome (IT)
- University of Latvia (LV)
- University of Edinburgh (GB)
Publication Details
- Journal
- European Radiology
- Published
- 2026-02-13
- DOI
- https://doi.org/10.1007/s00330-025-12146-3
- Citations
- 1
- Primary Topic
- Cardiac Imaging and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 31.92
Funders
- British Heart Foundation
- Deutsche Forschungsgemeinschaft
- Semmelweis Egyetem
- Rigshospitalet
- Berlin Institute of Health