Utilizing (serial) coronary computed tomography angiography (CCTA) to predict plaque progression and major adverse cardiac events (MACE): results, merits and challenges.

Autor: van Driest FY; Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands., Bijns CM; Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands., van der Geest RJ; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Broersen A; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Dijkstra J; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Scholte AJHA; Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands., Jukema JW; Department of Cardiology, Leiden Heart-Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. j.w.jukema@lumc.nl.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2022 May; Vol. 32 (5), pp. 3408-3422. Date of Electronic Publication: 2022 Jan 08.
DOI: 10.1007/s00330-021-08393-9
Abstrakt: Objectives: To present an overview of studies using serial coronary computed tomography angiography (CCTA) as a tool for finding both quantitative (changes) and qualitative plaque characteristics as well as epicardial adipose tissue (EAT) volume changes as predictors of plaque progression and/or major adverse cardiac events (MACE) and outline the challenges and advantages of using a serial non-invasive imaging approach for assessing cardiovascular prognosis.
Methods: A literature search was performed in PubMed, Embase, Web of Science, Cochrane Library and Emcare. All observational cohort studies were assessed for quality using the Newcastle-Ottawa Scale (NOS). The NOS score was then converted into Agency for Healthcare Research and Quality (AHRQ) standards: good, fair and poor.
Results: A total of 36 articles were analyzed for this review, 3 of which were meta-analyses and one was a technical paper. Quantitative baseline plaque features seem to be more predictive of MACE and/or plaque progression as compared to qualitative plaque features.
Conclusions: A critical review of the literature focusing on studies utilizing serial CCTA revealed that mainly quantitative baseline plaque features and quantitative plaque changes are predictive of MACE and/or plaque progression contrary to qualitative plaque features. Significant questions regarding the clinical implications of these specific quantitative and qualitative plaque features as well as the challenges of using serial CCTA have yet to be resolved in studies using this imaging technique.
Key Points: • Use of (serial) CCTA can identify plaque characteristics and plaque changes as well as changes in EAT volume that are predictive of plaque progression and/or major adverse events (MACE) at follow-up. • Studies utilizing serial CCTA revealed that mainly quantitative baseline plaque features and quantitative plaque changes are predictive of MACE and/or plaque progression contrary to qualitative plaque features. • Ultimately, serial CCTA is a promising technique for the evaluation of cardiovascular prognosis, yet technical details remain to be refined.
(© 2021. The Author(s), under exclusive licence to European Society of Radiology.)
Databáze: MEDLINE
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