Ik-Kyung Jang, MD, PhD, FACC

Identifying dangerous coronary plaques is crucial for preventing adverse cardiac events but has traditionally required invasive imaging.

A new study led by Ik-Kyung Jang, MD, PhD, FACC, and Stefano Andreaggi, MD, of the Mass General Brigham Heart and Vascular Institute, assessed whether non-invasive coronary computed tomography angiography (CCTA) scans could be used to reliably evaluate plaque vulnerability and identify patients at higher risk of future cardiac events.

Central to the study was the development of a unified Morphology‑Inflammation‑Burden, or “MIB,” score, which integrates three key features—plaque morphology (structural characteristics), pericoronary inflammation (inflammation of tissue surrounding the coronary arteries) and total plaque burden (overall amount of plaque).

The researchers applied this framework to CCTA scans from nearly 440 patients who also underwent gold‑standard invasive imaging during heart procedures, allowing the CCTA findings to be compared directly with established measures of plaque vulnerability.

After a median follow‑up of 31 months, patients with at least one untreated plaque exhibiting a high MIB score experienced a significantly higher rate of adverse cardiac events than those with lower scores.

Taken together, the findings highlight the potential of the MIB score to enhance cardiovascular risk assessment by shifting the focus away from individual high-risk plaque features and toward identifying vulnerable patients.

Published in JACC: Cardiovascular Imaging on June 16, 2026 | Read the paper: “Integrated Coronary CT Angiography Assessment of Plaque Vulnerability and Clinical Outcomes”

Summary reviewed by: Ik-Kyung Jang, MD, PhD, FACC, senior author