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High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data / AHMED SALEM

Swansea University Author: AHMED SALEM

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DOI (Published version): 10.23889/SUThesis.72008

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortalityworldwide, necessitating improved methods for early detection and risk stratification. Coronary CTangiography (CCTA) has emerged as a powerful, non-invasive imaging modality capable of identifyinghigh-ri...

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Published: Swansea 2026
Institution: Swansea University
Degree level: Doctoral
Degree name: Professional Doctorate
Supervisor: Halcox, J., and Stephens, J.
URI: https://cronfa.swan.ac.uk/Record/cronfa72008
first_indexed 2026-06-03T13:38:51Z
last_indexed 2026-06-04T08:37:50Z
id cronfa72008
recordtype RisThesis
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spelling 2026-06-03T14:45:43.9956531 v2 72008 2026-06-03 High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data d73e3a5cf5c6e089fe0ff5481df1dee2 AHMED SALEM AHMED SALEM true false 2026-06-03 Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortalityworldwide, necessitating improved methods for early detection and risk stratification. Coronary CTangiography (CCTA) has emerged as a powerful, non-invasive imaging modality capable of identifyinghigh-risk coronary plaque features that may predict future cardiovascular events. This thesis explores the role of CCTA in assessing plaque vulnerability, guiding risk factor optimisation, and influencing clinical outcomes in patients with stable and acute coronary syndrome (ACS).The methodology section outlines the study designs, data collection strategies, and analytical approaches used across multiple clinical studies, integrating both CCTA-based imaging assessments and real-world national cohort analyses. The thesis then presents several key investigations, beginning with a real-world analysis of secondary prevention in high-risk patients with type 2 diabetes, evaluating the achievement of European Society of Cardiology (ESC) guideline-recommended risk factor targets. This is followed by a detailed characterisation of high-risk coronary plaques, including the novel CT-defined thin-cap fibroatheroma (CT-TCFA), in patients undergoing CCTA for stable chest pain. Further, the research assesses how high-risk plaque features identified on CCTA influence cardiovascular risk optimisation, medication intensification, and clinical decision-making. The spatial distribution of vulnerable plaques within the coronary tree is also analysed to provide insights into the patterns of plaque progression and rupture potential. Lastly, as a future work, I’m planning to explore the potential impact of oral semaglutide on coronary artery disease progression following ACS, evaluating its role in modulating atherosclerotic plaque burden and stabilizing high-risk lesions. Collectively, this body of work highlights the critical role of CCTA in refining cardiovascular risk assessment, facilitating early intervention, and guiding therapeutic strategies to improve patient outcomes. The findings underscore the need for a more personalised approach to cardiovascular prevention, leveraging advanced imaging and targeted pharmacotherapy to mitigate the burden of ASCVD. E-Thesis Swansea CCTA, vulnerable plaque, CT-TCFA, cardiovascular prevention, type 2 diabetes, semaglutide 28 5 2026 2026-05-28 10.23889/SUThesis.72008 COLLEGE NANME COLLEGE CODE Swansea University Halcox, J., and Stephens, J. Doctoral Professional Doctorate Swansea Bay University Hospital Swansea Bay University Hospital 2026-06-03T14:45:43.9956531 2026-06-03T14:31:44.7227434 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science AHMED SALEM 1 72008__36854__6bf8b7693d2542809874d24ccc17ddf9.pdf 2026_Ahmed_S.final.72008.pdf 2026-06-03T14:38:39.6528751 Output 2997604 application/pdf E-Thesis – open access true Copyright: the author, Ahmed Mohamed Salem, 2026 true eng
title High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
spellingShingle High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
AHMED SALEM
title_short High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
title_full High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
title_fullStr High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
title_full_unstemmed High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
title_sort High-Risk Coronary Plaques and Cardiovascular Prevention: Insights from Coronary Computed Tomography Angiography and Real-World Data
author_id_str_mv d73e3a5cf5c6e089fe0ff5481df1dee2
author_id_fullname_str_mv d73e3a5cf5c6e089fe0ff5481df1dee2_***_AHMED SALEM
author AHMED SALEM
author2 AHMED SALEM
format E-Thesis
publishDate 2026
institution Swansea University
doi_str_mv 10.23889/SUThesis.72008
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
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description Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortalityworldwide, necessitating improved methods for early detection and risk stratification. Coronary CTangiography (CCTA) has emerged as a powerful, non-invasive imaging modality capable of identifyinghigh-risk coronary plaque features that may predict future cardiovascular events. This thesis explores the role of CCTA in assessing plaque vulnerability, guiding risk factor optimisation, and influencing clinical outcomes in patients with stable and acute coronary syndrome (ACS).The methodology section outlines the study designs, data collection strategies, and analytical approaches used across multiple clinical studies, integrating both CCTA-based imaging assessments and real-world national cohort analyses. The thesis then presents several key investigations, beginning with a real-world analysis of secondary prevention in high-risk patients with type 2 diabetes, evaluating the achievement of European Society of Cardiology (ESC) guideline-recommended risk factor targets. This is followed by a detailed characterisation of high-risk coronary plaques, including the novel CT-defined thin-cap fibroatheroma (CT-TCFA), in patients undergoing CCTA for stable chest pain. Further, the research assesses how high-risk plaque features identified on CCTA influence cardiovascular risk optimisation, medication intensification, and clinical decision-making. The spatial distribution of vulnerable plaques within the coronary tree is also analysed to provide insights into the patterns of plaque progression and rupture potential. Lastly, as a future work, I’m planning to explore the potential impact of oral semaglutide on coronary artery disease progression following ACS, evaluating its role in modulating atherosclerotic plaque burden and stabilizing high-risk lesions. Collectively, this body of work highlights the critical role of CCTA in refining cardiovascular risk assessment, facilitating early intervention, and guiding therapeutic strategies to improve patient outcomes. The findings underscore the need for a more personalised approach to cardiovascular prevention, leveraging advanced imaging and targeted pharmacotherapy to mitigate the burden of ASCVD.
published_date 2026-05-28T06:39:49Z
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score 11.108426

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