Coronary artery disease grading by cardiac CT for predicting outcome in patients with stable angina

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art_OEING_Coronary_artery_disease_grading_by_cardiac_CT_for_2023.PDF (547.33 KB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
OEING, Christian U.
MATHESON, Matthew B.
OSTOVANEH, Mohammad R.
ROCHITTE, Carlos E.
CHEN, Marcus Y.
PIESKE, Burkert
KOFOED, Klaus F.
SCHUIJF, Joanne D.
NIINUMA, Hiroyuki
DEWEY, Marc
Citação
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, v.17, n.5, p.310-317, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The coronary atheroma burden drives major adverse cardiovascular events (MACE) in patients with suspected coronary heart disease (CHD). However, a consensus on how to grade disease burden for effective risk stratification is lacking. The purpose of this study was to compare the effectiveness of common CHD grading tools to risk stratify symptomatic patients. Methods: We analyzed the 5-year outcome of 381 prospectively enrolled patients in the CORE320 international, multicenter study using baseline clinical and cardiac computer-tomography (CT) imaging characteristics, including coronary artery calcium score (CACS), percent atheroma volume, ""high-risk"" plaque, disease severity grading using the CAD-RADS, and two simplified CAD staging systems. We applied Cox proportional hazard models and area under the curve (AUC) analysis to predict MACE or hard MACE, defined as death, myocardial infarction, or stroke. Analyses were stratified by a history of CHD. Additional forward selection analysis was performed to evaluate incremental value of metrics. Results: Clinical characteristics were the strongest predictors of MACE in the overall cohort. In patients without history of CHD, CACS remained the only independent predictor of MACE yielding an AUC of 73 (CI 67-79) vs. 64 (CI 57-70) for clinical characteristics. Noncalcified plaque volume did not add prognostic value. Simple CHD grading schemes yielded similar risk stratification as the CAD-RADS classification. Forward selection analysis confirmed prominent role of CACS and revealed usefulness of functional testing in subgroup with known CHD. Conclusion: In patients referred for invasive angiography, a history of CHD was the strongest predictor of MACE. In patients without history of CHD, a coronary calcium score yielded at least equal risk stratification vs. more complex CHD grading.
Palavras-chave
Coronary heart disease, Coronary atherosclerosis, Coronary imaging, CT, Angina
URI
https://observatorio.fm.usp.br/handle/OPI/58323
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/64
Artigos e Materiais de Revistas Científicas - ODS/03