Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry
| Autor: | Sachio Kuribayashi, Hiroyuki Daida, Kazuhiro Kobuke, Shinichiro Fujimoto, Hideya Yamamoto, Shunichi Miyazaki, Yoshitaka Iwanaga, Yasuki Kihara, Takashi Fujii, Tomohiro Kawasaki |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Computed Tomography Angiography Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Risk Assessment Severity of Illness Index 030218 nuclear medicine & medical imaging Coronary artery disease 03 medical and health sciences 0302 clinical medicine Japan Predictive Value of Tests Risk Factors Internal medicine Post-hoc analysis Humans Medicine Radiology Nuclear Medicine and imaging Registries Vascular Calcification Aged business.industry Coronary artery calcium score Hazard ratio Coronary Stenosis Middle Aged Prognosis medicine.disease Coronary Vessels Predictive value Plaque Atherosclerotic Confidence interval Stenosis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Computed Tomography. 15:148-153 |
| ISSN: | 1934-5925 |
| Popis: | Background Whether coronary plaque characteristics assessed in coronary computed tomography angiography (CCTA) in association with the coronary artery calcium score (CACS) have predictive value for coronary events is unclear. We aimed to examine the predictive value of the CACS and plaque characteristics for the occurrence of coronary events. Methods Among 2802 patients who were analyzed in the PREDICT registry, 2083 with suspected coronary artery disease (CAD) were studied using post hoc analysis. High-risk plaques were defined as having ≥2 adverse characteristics, such as low computed tomographic attenuation, positive remodeling, spotty calcification, and napkin-ring sign. An adjudicative composite of coronary events (cardiac death, nonfatal acute coronary syndrome, and coronary revascularization ≥3 months after indexed CCTA) were analyzed. Results Seventy-three (3.5%) patients had coronary events and 313 (15.0%) had high-risk plaques. Multivariate Cox proportional hazard analysis showed that high-risk plaques remained an independent predictor of coronary events (adjusted hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.13–3.34, P = 0.0154), as well as the log-transformed CACS (adjusted HR 1.24, 95% CI 1.11–1.39, P = 0.0002) and the presence of obstructive stenosis (adjusted HR 5.63, 95% CI 3.22–10.12, P 0.0001). In subgroup analyses, high-risk plaques were independently predictive only in the low CACS class ( Conclusion This study shows that assessment of adverse features by coronary plaque imaging independently predicts coronary events in patients with suspected CAD and a low CACS. Our findings suggest that the clinical value of high-risk plaques to CACS and stenosis assessment appears marginal. |
| Databáze: | OpenAIRE |
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