title: Prognostic Determinants of Coronary Atherosclerosis in Stable Ischemic Heart Disease: Anatomy, Physiology, or Morphology?
abstract: Risk stratification in patients with stable ischemic heart disease is essential to guide treatment decisions. In this regard, whether coronary anatomy, physiology, or plaque morphology is the best determinant of prognosis (and driver an effective therapeutic risk reduction) remains one of the greatest ongoing debates in cardiology. In the present report, we review the evidence for each of these characteristics and explore potential algorithms that may enable a practical diagnostic and therapeutic strategy for the management of patients with stable ischemic heart disease.
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Amir
authors.initials: A
authors.lastname: Ahmadi
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Leslee J
authors.initials: LJ
authors.lastname: Shaw
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Todd C
authors.initials: TC
authors.lastname: Villines
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Morton J
authors.initials: MJ
authors.lastname: Kern
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Harvey
authors.initials: H
authors.lastname: Hecht
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: David
authors.initials: D
authors.lastname: Erlinge
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Ori
authors.initials: O
authors.lastname: Ben-Yehuda
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Eloisa
authors.initials: E
authors.lastname: Arbustini
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Patrick
authors.initials: P
authors.lastname: Serruys
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.).
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.affiliation: From the Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY (A.A., H.H., J.N.); Columbia University Medical Center, Cardiovascular Research Foundation, New York, NY (G.W.S., A.M.); University of British Columbia, Vancouver, British Columbia, Canada (A.A., J.L.); Emory University School of Medicine, Atlanta, GA (L.J.S.); Walter Reed National Military Medical Center, Bethesda, MD (T.C.V.); University of California Irvine (M.J.K.); Lund University, Sweden (D.E.); University of California San Diego (O.B.-Y.); Policlinico San Matteo Pavia Fondazione, Pravia, Italy (E.A.); Imperial College, London, United Kingdom (P.S.); and Leesburg Regional Medical Centre, FL (H.M.G.-G.). jagat.narula@mountsinai.org.
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
mesh_terms: D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D011379:Prognosis; D018570:Risk Assessment
keywords: coronary artery disease; fractional flow reserve; multidetector computed tomography; myocardial ischemia; plaque, atherosclerotic