{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:55Z","timestamp":1786649815974,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>We hypothesized that quantification of coronary atherosclerotic plaque burden by artificial intelligence-guided quantitative computed tomography can identify patients who derive outcome benefit from lipid-lowering medication (LLM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this observational cohort study, consecutive symptomatic patients undergoing coronary computed tomography angiography for suspected coronary artery disease (CAD) were assessed for percent atheroma volume (PAV) by artificial intelligence-guided quantitative computed tomography. The use of LLM was assessed based on drug purchase registry data within 6 months after coronary computed tomography angiography. Patients were followed for the composite of death, myocardial infarction, and unstable angina for a median of 6.9 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 2269 patients (median age, 63 years; 42% men), 1261 (56%) patients used LLM after coronary computed tomography angiography, and 255 (11%) experienced the composite end point during follow-up. The median PAV was 6.6% among users and 1.4% among nonusers of LLM (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Adapting the previously proposed CAD stages for artificial intelligence-guided quantitative computed tomography, the use of LLM (versus no use) was associated with improved outcomes among the 910 patients with PAV &gt;5% (annual event rate, 2.62% versus 4.14%; adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002), even in the absence of obstructive CAD, but not among the 1359 patients with PAV \u22645% (annual event rate, 0.94% versus 0.65%; adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.717). An adjusted Cox regression analysis, including interaction between PAV and LLM, suggested a PAV threshold between 4% and 10% for gaining prognostic benefit from LLM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In symptomatic patients with suspected CAD, LLM after coronary computed tomography angiography was associated with a lower rate of adverse events during long-term follow-up among those with PAV &gt;5%, even in the absence of obstructive CAD. The quantification of coronary atherosclerotic plaque burden is a potential marker to guide preventive lipid-lowering therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circimaging.125.018840","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:00:13Z","timestamp":1775466013000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Quantitative Coronary Atherosclerotic Plaque Burden From CCTA and the Benefit From Lipid-Lowering Medication"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-4635","authenticated-orcid":true,"given":"Teemu","family":"Maaniitty","sequence":"first","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku, Finland (T.M., S.B., J.K., A.S.)."},{"name":"Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Finland (T.M., 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A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3156-9593","authenticated-orcid":true,"given":"Juhani","family":"Knuuti","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku, Finland (T.M., S.B., J.K., A.S.)."},{"name":"Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Finland (T.M., J.K.)."},{"name":"Faculty of Medicine, University of Turku, Finland (J.J.B., J.K., A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-0893","authenticated-orcid":true,"given":"Antti","family":"Saraste","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku, Finland (T.M., S.B., J.K., A.S.)."},{"name":"Heart Center, Turku University Hospital and University of Turku, Finland (J.J.B., A.S.)."},{"name":"Faculty of Medicine, University of 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