Vulnerable Coronary Plaques on CT Angiography: Imaging Biomarkers, Artificial Intelligence, and Emerging Technologies for Risk Stratification

Background

Coronary artery disease remains the leading cause of morbidity and mortality worldwide. Increasing evidence has demonstrated that many acute coronary events originate not from severely obstructive lesions but from structurally unstable atherosclerotic plaques. Consequently, the identification of vulnerable plaques has become a major objective in contemporary cardiovascular imaging. Coronary computed tomography angiography (CCTA) has evolved from a modality primarily focused on luminal stenosis assessment into a comprehensive non-invasive technique capable of evaluating plaque morphology, composition, and overall coronary atherosclerotic burden.