Clinical Research Directory

Inclusion Criteria: * Adults aged 18 to 80 years * Ability to provide written informed consent * Patients undergoing coronary computed tomography angiography (CCTA) for suspected coronary artery disease or for diagnostic work-up of stabilized acute coronary syndrome * Presence of at least one target coronary lesion meeting one of the following CCTA criteria: * Severe coronary diameter stenosis (70-99%) in one or more coronary arteries according to CAD-RADS 4A or 4B classification and at least one of the following: * CT-derived fractional flow reserve (CT-FFR) ≤0.80 * At least 2 high-risk plaque characteristics, including: * Low attenuation plaque density \<30 Hounsfield units * Positive remodeling index \>1.1 * Napkin-ring sign * Spotty calcification * Left main coronary artery stenosis ≥50% * Ostial or proximal left anterior descending artery, dominant left circumflex artery, or dominant right coronary artery stenosis ≥50% and at least one of the following: * CT-FFR ≤0.80 * At least 2 high-risk plaque characteristics, including: * Low attenuation plaque density \<30 Hounsfield units * Positive remodeling index \>1.1 * Napkin-ring sign * Spotty calcification * Planned clinically indicated invasive coronary angiography with operator decision to proceed with PCI Exclusion Criteria: * Contraindication to iodinated contrast media, including severe allergy or contrast-induced nephropathy * Poor-quality or non-diagnostic CCTA imaging * Target lesions involving in-stent restenosis * Chronic total occlusion target lesions * Operator decision to treat a vessel not identified as a target vessel by the CCTA core laboratory analysis * Pregnancy or breastfeeding * Patients referred for coronary artery bypass graft surgery after invasive coronary angiography * Participation in another investigational drug or drug-coated device study * Inability to provide informed consent