biostudies-literatureFerraro RALeading Foreign Research Institute Recruitment ProgramNational Research Foundation of KoreaNIH973-980https://www.ebi.ac.uk/biostudies/studies/S-EPMC7440964biostudies-literatureUnknown21(9)<h4>Aims</h4>High-risk plaque (HRP) and non-obstructive coronary artery disease independently predict adverse events, but their importance to future culprit lesions has not been resolved. We sought to determine in patients prior to confirmed acute coronary syndrome (ACS) the association between lesion percent diameter stenosis (%DS), and the absolute number and prevalence of HRP. The secondary objective was to examine the relative importance of non-obstructive HRP in future culprit lesions.<h4>Methods and results</h4>Within the ICONIC study, a nested case-control study of patients undergoing coronary computed tomographic angiography (coronary CT), we included ACS cases with culprit lesions confirmed by invasive coronary angiography and coregistered to baseline coronary CT. Quantitative CT European heart journal. Cardiovascular ImagingNon-obstructive high-risk plaques increase the risk of future culprit lesions comparable to obstructive plaques without high-risk features: the ICONIC study.PMC7440964HL115150Andreini DCademartiri FLu YRaff GLAl'Aref SJLin FYStone PHChinnaiyan KBudoff MJLeipsic JBerman DSVillines TCCho IDanad IConte EKim YJvan Rosendael ARMarques HPlank FGransar HChow BJWde Araujo Goncalves PAl-Mallah MHLee SEVirmani RBax JJMaffei EFerraro RAMin JKHadamitzky MNarula JChang HJBaskaran LShaw LJSamady HFeuchtner GPontone GCury RCfalseNon-obstructive high-risk plaques increase the risk of future culprit lesions comparable to obstructive plaques without high-risk features: the ICONIC study.<h4>Aims</h4>High-risk plaque (HRP) and non-obstructive coronary artery disease independently predict adverse events, but their importance to future culprit lesions has not been resolved. We sought to determine in patients prior to confirmed acute coronary syndrome (ACS) the association between lesion percent diameter stenosis (%DS), and the absolute number and prevalence of HRP. The secondary objective was to examine the relative importance of non-obstructive HRP in future culprit lesions.<h4>Methods and results</h4>Within the ICONIC study, a nested case-control study of patients undergoing coronary computed tomographic angiography (coronary CT), we included ACS cases with culprit lesions confirmed by invasive coronary angiography and coregistered to baseline coronary CT. Quantitative CT 2020-01-01T00:00:00Z2020 Sep2025-04-04T13:57:05.878Z2022-02-11T10:03:14.734ZS-EPMC74409643253563610.1093/ehjci/jeaa048