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Peer-reviewedCC BY-NC-SAPostepy w kardiologii interwencyjnej = Advances in interventional cardiology

Non-invasive methods of risk assessment in patients with chronic coronary syndrome: which patients will experience an acute event?

  1. 11 Department of Cardiology, Medical University of Warsaw, Poland

Abstract

Patients with chronic coronary syndrome (CCS) represent a particularly vulnerable group of coronary artery disease (CAD) patients, since predicting the progression of CCS to an acute state and subsequent major cardiovascular events remains challenging despite advances in risk stratification methods. Currently, clinicians implement a multidimensional diagnostic approach and rely on several non-invasive techniques when stratifying risk of major adverse cardiovascular events in CCS patients. Models such as pre-test probability are useful for initial assessment, but their clinical performance remains limited. More advanced modalities such as coronary computed tomography angiography, cardiovascular magnetic resonance, positron emission tomography, and single photon emission computed tomography have demonstrated high diagnostic accuracy and prognostic value. Coronary computed tomography angiography has emerged at the forefront, as it provides a detailed and comprehensive analysis of cardiovascular risk beyond luminal stenosis. Newly developed methods focused on image-derived markers of inflammation, including epicardial adipose tissue, and circulating biomarkers of inflammation provide a broader view of CAD pathology and further enhance the risk evaluation strategies. Nevertheless, the application of these methods in contemporary clinical practice remains limited by high data heterogeneity, lack of standardization, and the lack of expert consensus. This review article aims to critically appraise the strengths and limitations of the current non-invasive strategies and to discuss possible future prospects in this field.

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BibTeX
@article{pajak2026noninvasive,
  title = {{Non-invasive methods of risk assessment in patients with chronic coronary syndrome: which patients will experience an acute event?}},
  author = {Kacper J. Pająk and Kamil Tkacz and Natalia Kaleta and Julia Krawczyk and Aleksandra Gąsecka},
  journal = {Postepy w kardiologii interwencyjnej = Advances in interventional cardiology},
  year = {2026},
  month = sep,
  doi = {10.5114/aic.2026.164776},
  url = {https://europepmc.org/article/PMC/PMC13721059},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Non-invasive methods of risk assessment in patients with chronic coronary syndrome: which patients will experience an acute event?
AU  - Kacper J. Pająk
AU  - Kamil Tkacz
AU  - Natalia Kaleta
AU  - Julia Krawczyk
AU  - Aleksandra Gąsecka
PY  - 2026
DA  - 2026/09/01
JO  - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology
DO  - 10.5114/aic.2026.164776
UR  - https://europepmc.org/article/PMC/PMC13721059
AB  - Patients with chronic coronary syndrome (CCS) represent a particularly vulnerable group of coronary artery disease (CAD) patients, since predicting the progression of CCS to an acute state and subsequent major cardiovascular events remains challenging despite advances in risk stratification methods. Currently, clinicians implement a multidimensional diagnostic approach and rely on several non-invasive techniques when stratifying risk of major adverse cardiovascular events in CCS patients. Models such as pre-test probability are useful for initial assessment, but their clinical performance remains limited. More advanced modalities such as coronary computed tomography angiography, cardiovascular magnetic resonance, positron emission tomography, and single photon emission computed tomography have demonstrated high diagnostic accuracy and prognostic value. Coronary computed tomography angiography has emerged at the forefront, as it provides a detailed and comprehensive analysis of cardiovascular risk beyond luminal stenosis. Newly developed methods focused on image-derived markers of inflammation, including epicardial adipose tissue, and circulating biomarkers of inflammation provide a broader view of CAD pathology and further enhance the risk evaluation strategies. Nevertheless, the application of these methods in contemporary clinical practice remains limited by high data heterogeneity, lack of standardization, and the lack of expert consensus. This review article aims to critically appraise the strengths and limitations of the current non-invasive strategies and to discuss possible future prospects in this field.
SN  - 1734-9338
SN  - 1897-4295
ER  -