Filippo Cademartiri: The DECIDE Registry Tackles a Critical Gap In Cardiovascular Care
Filippo Cademartiri, Consultant Advanced Cardiovascular Imaging at UPMC Salvator Mundi International Hospital, shared on LinkedIn about a recent article by Sarah Rinehart et al, adding:
”Seeing plaque is one thing. Acting on it is another.
The DECIDE Registry tackles a critical gap in cardiovascular care:
What happens after we detect atherosclerotic plaque on coronary CTA?
Key insight
Coronary CTA is not just diagnostic – it’s actionable.
In this study:
Detection of plaque led to significant intensification of preventive therapies
Particularly:
- Statins
- Antiplatelet strategies
- Risk factor optimization
Imaging didn’t just describe disease.
It changed clinical behavior.
But here’s the uncomfortable truth
Even when plaque is clearly identified:
- Preventive therapies are still underutilized
- Treatment escalation is inconsistent
- Many patients remain undertreated despite visible disease
What this really means
We’ve solved the visibility problem.
We can now detect:
- Non-obstructive plaque
- Early atherosclerosis
- High-risk features
But we haven’t fully solved the decision problem.
Paradigm shift
This study reinforces a key concept:
Atherosclerosis should trigger treatment – not just stenosis.
Because:
- Events come from plaque
- Not just from flow-limiting lesions
Clinical takeaway
Coronary CTA is evolving from:
‘Do you have a blockage?’ to ‘Do you have disease – and how aggressively should we treat it?’
Final thought
If you can see plaque and still don’t act…
The problem is no longer imaging. It’s mindset.
And that’s where the real transformation in cardiovascular care must happen.”
Title: Guiding Preventive Care Strategies for Patients With Atherosclerotic Plaque on Coronary CTA: Primary Outcomes of the DECIDE Registry
Authors: Sarah Rinehart, Ron Blankstein, Cian P. McCarthy, James L. Januzzi, Markus Scherer, Wesley T. O’Neal, Philip Green, Joseph Puma, Frank Corrigan, Jaydip Datta, Jens Eichhorn, Thomas Stuckey, Omar Khalique, Ziad Ali, Nicholas Ng, Whitney Huey, Sarah Mullen, Campbell Rogers, Leslee J. Shaw, the DECIDE Investigators
Read the Full Article on JACC Imaging
Stay updated on all scientific advances with Hemostasis Today.
-
Apr 4, 2026, 17:51Rabiah Alnoshan: A Pactical, Bedside Focused Approach to Bleeding
-
Apr 4, 2026, 17:50Rob Maloney: How Our Camp Brings Relief to Children with Bleeding Disorders and Their Families
-
Apr 4, 2026, 16:11Shiny K. Kajal: Platelet Transfusion Is a Clinical Decision, Not a Reflex
-
Apr 4, 2026, 16:09Khaled Musallam: Revisiting Global Anemia Burden with Revised WHO Hemoglobin Criteria
-
Apr 4, 2026, 16:07Rabi Hanna: RUBY Trial Shows Life-Changing CRISPR Therapy for Sickle Cell Disease
-
Apr 4, 2026, 16:06Hossam El Benawi: Is Ultrasound Alone Enough to Diagnose CVI?
-
Apr 4, 2026, 16:04Seema Dawood: How Vitamin B12 and Folate Deficiency Cause Megaloblastic Anemia
-
Apr 4, 2026, 14:55Thomas Rocco Jr: Adverse Cardiovascular Outcomes Associated with Metabolic Syndrome in Non-Obese Patients with Heart Failure
-
Apr 4, 2026, 14:40Abdul Mannan: A Clinical Framework for Direct Oral Anticoagulant Reversal in Acute Bleeding