Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry
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 t...
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| Veröffentlicht in: | Journal of cardiovascular computed tomography 2021-03, Vol.15 (2), p.148-153 |
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| creator | Yamamoto, Hideya Kihara, Yasuki Fujimoto, Shinichiro Daida, Hiroyuki Kobuke, Kazuhiro Iwanaga, Yoshitaka Miyazaki, Shunichi Kawasaki, Tomohiro Fujii, Takashi Kuribayashi, Sachio |
| description | 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.
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.
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 ( |
| doi_str_mv | 10.1016/j.jcct.2020.06.198 |
| format | Article |
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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.
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 (<100).
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.
It is still unclear 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. To clarify this hypothesis, we studied 2083 suspected coronary artery disease patients in this PREDICT post hoc analysis. High-risk plaque was independently predictive in the lower CACS classes (<100) but it was not independent in the high CACS class (≥100). 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. [Display omitted]</description><identifier>ISSN: 1934-5925</identifier><identifier>EISSN: 1876-861X</identifier><identifier>DOI: 10.1016/j.jcct.2020.06.198</identifier><identifier>PMID: 32826204</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Coronary artery calcium score ; Coronary computed tomography angiography ; Coronary event ; High-risk plaque ; Plaque characteristics ; Prognosis</subject><ispartof>Journal of cardiovascular computed tomography, 2021-03, Vol.15 (2), p.148-153</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-8e8e114811e871825f77896d1ae605aac6d936ef0e38dd76cd273b6ddeac46373</citedby><cites>FETCH-LOGICAL-c400t-8e8e114811e871825f77896d1ae605aac6d936ef0e38dd76cd273b6ddeac46373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcct.2020.06.198$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32826204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamamoto, Hideya</creatorcontrib><creatorcontrib>Kihara, Yasuki</creatorcontrib><creatorcontrib>Fujimoto, Shinichiro</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Kobuke, Kazuhiro</creatorcontrib><creatorcontrib>Iwanaga, Yoshitaka</creatorcontrib><creatorcontrib>Miyazaki, Shunichi</creatorcontrib><creatorcontrib>Kawasaki, Tomohiro</creatorcontrib><creatorcontrib>Fujii, Takashi</creatorcontrib><creatorcontrib>Kuribayashi, Sachio</creatorcontrib><title>Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry</title><title>Journal of cardiovascular computed tomography</title><addtitle>J Cardiovasc Comput Tomogr</addtitle><description>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.
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.
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 (<100).
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.
It is still unclear 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. To clarify this hypothesis, we studied 2083 suspected coronary artery disease patients in this PREDICT post hoc analysis. High-risk plaque was independently predictive in the lower CACS classes (<100) but it was not independent in the high CACS class (≥100). 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. [Display omitted]</description><subject>Coronary artery calcium score</subject><subject>Coronary computed tomography angiography</subject><subject>Coronary event</subject><subject>High-risk plaque</subject><subject>Plaque characteristics</subject><subject>Prognosis</subject><issn>1934-5925</issn><issn>1876-861X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE1rGzEQhkVoaNK0fyCHomMvu9XHrlYbcilu2gYCMSWF3sRkNFvLrC1XWht87w-vjJMccxrBPO_L6GHsUopaCmk-L-sl4lQroUQtTC17e8LOpe1MZY38_aa8e91Uba_aM_Yu56UQbSeFfcvOtLLKKNGcs3_zRD7gFHbEdzBuiceBTwviGFNcQ9pzSBOVgTBi2K54LgvisPYc_A7WSJ5vRvhbgriABFjgkKeA-YrPY574ImKhYdznkJ-75z9vvt7OHniiP4VN-_fsdIAx04enecF-fbt5mP2o7u6_386-3FXYCDFVlixJ2VgpyXbSqnboOtsbL4GMaAHQ-F4bGgRp631n0KtOPxrvCbAxutMX7NOxd5NiuThPbhUy0jjCmuI2O9Voo3tphS2oOqKYYs6JBrdJYVV8OCncwb5buoN9d7DvhHHFfgl9fOrfPq7Iv0SedRfg-ghQ-eUuUHIZAx0khkSlzMfwWv9_AAuX8Q</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Yamamoto, Hideya</creator><creator>Kihara, Yasuki</creator><creator>Fujimoto, Shinichiro</creator><creator>Daida, Hiroyuki</creator><creator>Kobuke, Kazuhiro</creator><creator>Iwanaga, Yoshitaka</creator><creator>Miyazaki, Shunichi</creator><creator>Kawasaki, Tomohiro</creator><creator>Fujii, Takashi</creator><creator>Kuribayashi, Sachio</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202103</creationdate><title>Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry</title><author>Yamamoto, Hideya ; Kihara, Yasuki ; Fujimoto, Shinichiro ; Daida, Hiroyuki ; Kobuke, Kazuhiro ; Iwanaga, Yoshitaka ; Miyazaki, Shunichi ; Kawasaki, Tomohiro ; Fujii, Takashi ; Kuribayashi, Sachio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-8e8e114811e871825f77896d1ae605aac6d936ef0e38dd76cd273b6ddeac46373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Coronary artery calcium score</topic><topic>Coronary computed tomography angiography</topic><topic>Coronary event</topic><topic>High-risk plaque</topic><topic>Plaque characteristics</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamamoto, Hideya</creatorcontrib><creatorcontrib>Kihara, Yasuki</creatorcontrib><creatorcontrib>Fujimoto, Shinichiro</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Kobuke, Kazuhiro</creatorcontrib><creatorcontrib>Iwanaga, Yoshitaka</creatorcontrib><creatorcontrib>Miyazaki, Shunichi</creatorcontrib><creatorcontrib>Kawasaki, Tomohiro</creatorcontrib><creatorcontrib>Fujii, Takashi</creatorcontrib><creatorcontrib>Kuribayashi, Sachio</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular computed tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamamoto, Hideya</au><au>Kihara, Yasuki</au><au>Fujimoto, Shinichiro</au><au>Daida, Hiroyuki</au><au>Kobuke, Kazuhiro</au><au>Iwanaga, Yoshitaka</au><au>Miyazaki, Shunichi</au><au>Kawasaki, Tomohiro</au><au>Fujii, Takashi</au><au>Kuribayashi, Sachio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry</atitle><jtitle>Journal of cardiovascular computed tomography</jtitle><addtitle>J Cardiovasc Comput Tomogr</addtitle><date>2021-03</date><risdate>2021</risdate><volume>15</volume><issue>2</issue><spage>148</spage><epage>153</epage><pages>148-153</pages><issn>1934-5925</issn><eissn>1876-861X</eissn><abstract>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.
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.
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 (<100).
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.
It is still unclear 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. To clarify this hypothesis, we studied 2083 suspected coronary artery disease patients in this PREDICT post hoc analysis. High-risk plaque was independently predictive in the lower CACS classes (<100) but it was not independent in the high CACS class (≥100). 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. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32826204</pmid><doi>10.1016/j.jcct.2020.06.198</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Coronary artery calcium score Coronary computed tomography angiography Coronary event High-risk plaque Plaque characteristics Prognosis |
| title | Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry |
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