A system (100) includes a computer readable storage medium (122) with computer executable instructions (124), including: a predictor (126) configured to determine a baseline coronary state and a predicted coronary state from contrast enhanced cardiac computed tomography volumetric image data and a model of an effect of one or more substances on characteristics effecting the coronary state. The system further includes a processor (120) configured to execute the predictor to determine the baseline coronary state and the predicted coronary state from the contrast enhanced cardiac computed tomography volumetric image data and the model of the effect of one or more of the substances on the characteristics effecting the coronary state. The system further includes a display configured to display the baseline coronary state and the predicted coronary state.