DISTRIBUTION OF ATHEROSCLEROTIC PLAQUES IN CORONARY ARTERIAL SEGMENTS USING COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY: AN OBSERVATIONAL STUDY IN PESHAWAR, PAKISTAN

Objective: To determine the prevalence, distribution pattern, and characteristics of atherosclerotic plaques in major coronary arterial segments using Computed Tomography Coronary Angiography (CCTA) in a tertiary care setting. Methods: A descriptive cross-sectional study was conducted at Rehman Medical Institute, Peshawar, involving 285 patients undergoing CCTA for suspected coronary artery disease (CAD). Angiographic images were analysed to identify plaque location (Left Anterior Descending [LAD], Right Coronary Artery [RCA], Left Circumflex [LCx]), segmental distribution (proximal, middle, distal), plaque type (calcified, non-calcified, mixed), and degree of stenosis. Data were analysed using SPSS. Results: The majority of patients were male (67.7%) with a peak age prevalence between 46–55 years (34.7%). The Left Anterior Descending (LAD) artery was the most affected vessel (62.1%), followed by the RCA (37.2%). Segmental analysis revealed that plaques were predominantly located in the proximal segments of both the LAD (68.9%) and RCA (59.2%). Calcified plaques were the most common type (58.0%), followed by mixed (22.6%) and non-calcified plaques (19.4%). Regarding severity, 21.4% of patients exhibited severe stenosis (>70%), while 42.5% showed no significant stenosis. Conclusion: Atherosclerosis in this population predominantly affects the proximal segment of the LAD artery. Calcified plaques are the most common morphology. These findings highlight the need for targeted screening and early intervention in middle-aged males in this region.