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.