Predictive Role of Photon Counting Computed Tomography in Acute Coronary Syndrom Patients

For patients with severe calcification or complex non-calcified plaques, we investigate wether PCCT can enable non-invasive, in vivo precise differentiation and quantitative measurement of plaque components (e.g., spotty calcification, necrotic core, fibrous tissue). Further we also study wether these quantitative imaging features can independently predict the risk of MACE in the short term and long term

Photon-counting detector CT (PCD-CT), as an innovative technology in the field of CT imaging, is gradually transforming the landscape of cardiac imaging. It differs significantly from conventional energy-integrating detector CT (EID-CT) in technical principles, bringing new possibilities for the diagnosis and assessment of heart diseases. This study will enrolled patients undergo standardized PCCT coronary angiography (CCTA) and make ultra-fine quantitative plaque analysis. Then at least 12 months of clinical follow-up will be performed. Finally correlation analysis between baseline plaque characteristics and follow-up endpoint events will be made.

Inclusion Criter: * Adult patients (≥18 years) with clinically diagnosed coronary artery disease or undergoing CCTA for chest pain/heart failure symptoms. * Able and willing to provide informed consent and complete scheduled follow-up visits. Exclusion Criteria: * History of iodine contrast agent allergy. * Severe renal insufficiency (eGFR \< 30 mL/min/1.73 m²). * History of prior coronary artery bypass grafting (CABG). * Pregnant or lactating women