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Filippo Cademartiri: The DECIDE Registry Tackles a Critical Gap In Cardiovascular Care
Filippo Cademartiri/LinkedIn
Apr 4, 2026, 17:51

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

Filippo Cademartiri: The DECIDE Registry Tackles a Critical Gap In Cardiovascular Care

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Campbell Rogers Cian P. McCarthy CTA DECIDE Filippo Cademartiri Frank Corrigan Health Hematology Hemostasis Hemostasis News Hemostasis Today JACC James L. Januzzi Jaydip Datta Jens Eichhorn Joseph Puma Leslee J Shaw Markus Scherer Medicine Nicholas Ng Omar Khalique Philip Green Plaque Ron Blankstein Sarah Mullen Sarah Rinehart Thomas Stuckey thrombosis Wesley T. O’Neal Whitney Huey Ziad Ali
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