P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up
Abstract Background Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification. Aims To define CT-imaging predictors for long–term...
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| creator | Senoner, T Plank, F Babieri, F Dichtl, W Beyer, C Friedrich, G Feuchtner, G M |
| description | Abstract
Background
Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification.
Aims
To define CT-imaging predictors for long–term outcomes.
Methods
1430 low-to-intermediate-risk patients (mean age 57.9 years; 44.4% females) were included into our prospective cohort study. Coronary Calcium Score (CCS) and CTA were performed. CTA was evaluated for: Stenosis severity (minimal |
| doi_str_mv | 10.1093/eurheartj/ehz746.0759 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehz746_0759</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehz746.0759</oup_id><sourcerecordid>10.1093/eurheartj/ehz746.0759</sourcerecordid><originalsourceid>FETCH-LOGICAL-c879-62c18f0e09ede7f9eb9460c736f173d24db3710bef202f7e67589112ff6ce0dd3</originalsourceid><addsrcrecordid>eNqN0MtOwzAQhWELgUS5PALSvEBaOxc7ZldVQJEqwaILdpHjjNsUJw62AypPT6si1qxm9Y90PkLuGJ0yKrMZjn6LysfdDLffIudTKgp5RiasSNNE8rw4JxPKZJFwXr5dkqsQdpTSkjM-Id0rZ0W2bDdb8G14h8GqjxGh3oN23vXK72GxnsPgsWl1BK180yoN-Il9DFCPEXoXQVmbaDUGhM75qGwb9_dgXb-BiL4D46x1XzAON-TCKBvw9vdek_Xjw3qxTFYvT8-L-SrRpZAJTzUrDUUqsUFhJNYy51SLjBsmsibNmzoTjNZoUpoagVwUpWQsNYZrpE2TXZPi9FZ7F4JHUw2-7Q5bKkarI1n1R1adyKoj2aGjp86Nwz-TH62tdTU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Senoner, T ; Plank, F ; Babieri, F ; Dichtl, W ; Beyer, C ; Friedrich, G ; Feuchtner, G M</creator><creatorcontrib>Senoner, T ; Plank, F ; Babieri, F ; Dichtl, W ; Beyer, C ; Friedrich, G ; Feuchtner, G M</creatorcontrib><description><![CDATA[Abstract
Background
Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification.
Aims
To define CT-imaging predictors for long–term outcomes.
Methods
1430 low-to-intermediate-risk patients (mean age 57.9 years; 44.4% females) were included into our prospective cohort study. Coronary Calcium Score (CCS) and CTA were performed. CTA was evaluated for: Stenosis severity (minimal<25%; mild<50%; moderate 50–70%; severe >70%) (CADRADS 1–4), total mixed plaque burden (G-score), high–risk-plaque criteria: 1) low attenuation plaque 2) Napkin-ring (“lunar-eclipse” sign) 3) spotty calcification 4) remodeling index
Primary endpoint was all-cause mortality, secondary endpoints cardiovascular mortality and composite (non-fatal and fatal) MACE.
Results
Over a follow-up of mean 10.55 years ±1.98 (range, 6.1–12.8), all-cause mortality rate was 106 (7.4%), cardiovascular mortality 25 (1.75%) and composite MACE 57 (4%).
In patients with negative CTA, cardiovascular mortality was 0% and composite MACE rate 0.2%.
Stenosis severity (CADRADS) was the strongest predictor for all 3 endpoints (p<0.001) on multivariate analysis (unadjusted and adjusted for risk factors, p<0.001) but calcium score >100 AU only predicted mortality on the unadjusted multivariate analysis (p=0.045) but not on the adjusted.
On multivariate analysis, G-score (p<0.0001), LAP<60HU and the Napkin-Ring predicted composite MACE (p<0.001) but not all-cause mortality, before and after adjusting for risk factors (p=0.007 and 0.001 for LAP<60HU and Napkin-Ring, respectively) while spotty calcification and remodeling index did not. 465 had calcium score zero and in 156 (33.5%) of those, noncalcified fibroatheroma were found (total rate, 11%), 4.9% had >50% stenosis. However only 1 patient with calcium score zero died while there were 6 MACE.
High risk plaque with “lunar eclipse”
Conclusions
Long-term prognosis is excellent if CTA is negative. Stenosis severity by CTA predicts all-cause and cardiovascular mortality, while calcium score predicts only mortality. Plaque burden and the high-risk plaque criteria LAP<60 and Napkin-Ring (syn. “lunar eclipse”) are strong predictors of MACE, but not all–cause mortality. Coronary CTA outperforms calcium scoring for risk stratification.]]></description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz746.0759</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids></links><search><creatorcontrib>Senoner, T</creatorcontrib><creatorcontrib>Plank, F</creatorcontrib><creatorcontrib>Babieri, F</creatorcontrib><creatorcontrib>Dichtl, W</creatorcontrib><creatorcontrib>Beyer, C</creatorcontrib><creatorcontrib>Friedrich, G</creatorcontrib><creatorcontrib>Feuchtner, G M</creatorcontrib><title>P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up</title><title>European heart journal</title><description><![CDATA[Abstract
Background
Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification.
Aims
To define CT-imaging predictors for long–term outcomes.
Methods
1430 low-to-intermediate-risk patients (mean age 57.9 years; 44.4% females) were included into our prospective cohort study. Coronary Calcium Score (CCS) and CTA were performed. CTA was evaluated for: Stenosis severity (minimal<25%; mild<50%; moderate 50–70%; severe >70%) (CADRADS 1–4), total mixed plaque burden (G-score), high–risk-plaque criteria: 1) low attenuation plaque 2) Napkin-ring (“lunar-eclipse” sign) 3) spotty calcification 4) remodeling index
Primary endpoint was all-cause mortality, secondary endpoints cardiovascular mortality and composite (non-fatal and fatal) MACE.
Results
Over a follow-up of mean 10.55 years ±1.98 (range, 6.1–12.8), all-cause mortality rate was 106 (7.4%), cardiovascular mortality 25 (1.75%) and composite MACE 57 (4%).
In patients with negative CTA, cardiovascular mortality was 0% and composite MACE rate 0.2%.
Stenosis severity (CADRADS) was the strongest predictor for all 3 endpoints (p<0.001) on multivariate analysis (unadjusted and adjusted for risk factors, p<0.001) but calcium score >100 AU only predicted mortality on the unadjusted multivariate analysis (p=0.045) but not on the adjusted.
On multivariate analysis, G-score (p<0.0001), LAP<60HU and the Napkin-Ring predicted composite MACE (p<0.001) but not all-cause mortality, before and after adjusting for risk factors (p=0.007 and 0.001 for LAP<60HU and Napkin-Ring, respectively) while spotty calcification and remodeling index did not. 465 had calcium score zero and in 156 (33.5%) of those, noncalcified fibroatheroma were found (total rate, 11%), 4.9% had >50% stenosis. However only 1 patient with calcium score zero died while there were 6 MACE.
High risk plaque with “lunar eclipse”
Conclusions
Long-term prognosis is excellent if CTA is negative. Stenosis severity by CTA predicts all-cause and cardiovascular mortality, while calcium score predicts only mortality. Plaque burden and the high-risk plaque criteria LAP<60 and Napkin-Ring (syn. “lunar eclipse”) are strong predictors of MACE, but not all–cause mortality. Coronary CTA outperforms calcium scoring for risk stratification.]]></description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqN0MtOwzAQhWELgUS5PALSvEBaOxc7ZldVQJEqwaILdpHjjNsUJw62AypPT6si1qxm9Y90PkLuGJ0yKrMZjn6LysfdDLffIudTKgp5RiasSNNE8rw4JxPKZJFwXr5dkqsQdpTSkjM-Id0rZ0W2bDdb8G14h8GqjxGh3oN23vXK72GxnsPgsWl1BK180yoN-Il9DFCPEXoXQVmbaDUGhM75qGwb9_dgXb-BiL4D46x1XzAON-TCKBvw9vdek_Xjw3qxTFYvT8-L-SrRpZAJTzUrDUUqsUFhJNYy51SLjBsmsibNmzoTjNZoUpoagVwUpWQsNYZrpE2TXZPi9FZ7F4JHUw2-7Q5bKkarI1n1R1adyKoj2aGjp86Nwz-TH62tdTU</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Senoner, T</creator><creator>Plank, F</creator><creator>Babieri, F</creator><creator>Dichtl, W</creator><creator>Beyer, C</creator><creator>Friedrich, G</creator><creator>Feuchtner, G M</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up</title><author>Senoner, T ; Plank, F ; Babieri, F ; Dichtl, W ; Beyer, C ; Friedrich, G ; Feuchtner, G M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-62c18f0e09ede7f9eb9460c736f173d24db3710bef202f7e67589112ff6ce0dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Senoner, T</creatorcontrib><creatorcontrib>Plank, F</creatorcontrib><creatorcontrib>Babieri, F</creatorcontrib><creatorcontrib>Dichtl, W</creatorcontrib><creatorcontrib>Beyer, C</creatorcontrib><creatorcontrib>Friedrich, G</creatorcontrib><creatorcontrib>Feuchtner, G M</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Senoner, T</au><au>Plank, F</au><au>Babieri, F</au><au>Dichtl, W</au><au>Beyer, C</au><au>Friedrich, G</au><au>Feuchtner, G M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract><![CDATA[Abstract
Background
Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification.
Aims
To define CT-imaging predictors for long–term outcomes.
Methods
1430 low-to-intermediate-risk patients (mean age 57.9 years; 44.4% females) were included into our prospective cohort study. Coronary Calcium Score (CCS) and CTA were performed. CTA was evaluated for: Stenosis severity (minimal<25%; mild<50%; moderate 50–70%; severe >70%) (CADRADS 1–4), total mixed plaque burden (G-score), high–risk-plaque criteria: 1) low attenuation plaque 2) Napkin-ring (“lunar-eclipse” sign) 3) spotty calcification 4) remodeling index
Primary endpoint was all-cause mortality, secondary endpoints cardiovascular mortality and composite (non-fatal and fatal) MACE.
Results
Over a follow-up of mean 10.55 years ±1.98 (range, 6.1–12.8), all-cause mortality rate was 106 (7.4%), cardiovascular mortality 25 (1.75%) and composite MACE 57 (4%).
In patients with negative CTA, cardiovascular mortality was 0% and composite MACE rate 0.2%.
Stenosis severity (CADRADS) was the strongest predictor for all 3 endpoints (p<0.001) on multivariate analysis (unadjusted and adjusted for risk factors, p<0.001) but calcium score >100 AU only predicted mortality on the unadjusted multivariate analysis (p=0.045) but not on the adjusted.
On multivariate analysis, G-score (p<0.0001), LAP<60HU and the Napkin-Ring predicted composite MACE (p<0.001) but not all-cause mortality, before and after adjusting for risk factors (p=0.007 and 0.001 for LAP<60HU and Napkin-Ring, respectively) while spotty calcification and remodeling index did not. 465 had calcium score zero and in 156 (33.5%) of those, noncalcified fibroatheroma were found (total rate, 11%), 4.9% had >50% stenosis. However only 1 patient with calcium score zero died while there were 6 MACE.
High risk plaque with “lunar eclipse”
Conclusions
Long-term prognosis is excellent if CTA is negative. Stenosis severity by CTA predicts all-cause and cardiovascular mortality, while calcium score predicts only mortality. Plaque burden and the high-risk plaque criteria LAP<60 and Napkin-Ring (syn. “lunar eclipse”) are strong predictors of MACE, but not all–cause mortality. Coronary CTA outperforms calcium scoring for risk stratification.]]></abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz746.0759</doi></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| title | P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up |
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