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

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorOEING, Christian U.
dc.contributor.authorMATHESON, Matthew B.
dc.contributor.authorOSTOVANEH, Mohammad R.
dc.contributor.authorROCHITTE, Carlos E.
dc.contributor.authorCHEN, Marcus Y.
dc.contributor.authorPIESKE, Burkert
dc.contributor.authorKOFOED, Klaus F.
dc.contributor.authorSCHUIJF, Joanne D.
dc.contributor.authorNIINUMA, Hiroyuki
dc.contributor.authorDEWEY, Marc
dc.contributor.authorCARLI, Marcelo F. di
dc.contributor.authorCOX, Christopher
dc.contributor.authorLIMA, Joao A. C.
dc.contributor.authorARBAB-ZADEH, Armin
dc.date.accessioned2024-02-15T15:03:13Z
dc.date.available2024-02-15T15:03:13Z
dc.date.issued2023
dc.description.abstractBackground: 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.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.sponsorshipNHLBI, National Institutes of Health, USA - Canon Medical Systems
dc.identifier.citationJOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, v.17, n.5, p.310-317, 2023
dc.identifier.doi10.1016/j.jcct.2023.07.004
dc.identifier.issn1934-5925
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58323
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INCeng
dc.relation.ispartofJournal of Cardiovascular Computed Tomography
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER SCIENCE INCeng
dc.subjectCoronary heart diseaseeng
dc.subjectCoronary atherosclerosiseng
dc.subjectCoronary imagingeng
dc.subjectCTeng
dc.subjectAnginaeng
dc.subject.othercomputed-tomography angiographyeng
dc.subject.othersystem cad-radseng
dc.subject.otherprognostic valueeng
dc.subject.othervulnerable plaqueeng
dc.subject.otherburdeneng
dc.subject.otherscoreeng
dc.subject.othercontinuumeng
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.subject.wosRadiology, Nuclear Medicine & Medical Imagingeng
dc.titleCoronary artery disease grading by cardiac CT for predicting outcome in patients with stable anginaeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryJapão
hcfmusp.affiliation.countryDinamarca
hcfmusp.affiliation.countryHolanda
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryAlemanha
hcfmusp.affiliation.countryisous
hcfmusp.affiliation.countryisode
hcfmusp.affiliation.countryisodk
hcfmusp.affiliation.countryisonl
hcfmusp.affiliation.countryisojp
hcfmusp.author.externalOEING, Christian U.:Johns Hopkins Univ Hosp, Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA; Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA; Charite Univ Med Berlin, Dept Cardiol Angiol & Intens Care Med, Charite Universitatsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany; Univ Med Berlin, Dept Cardiol Angiol & Intens Care Med, Angiol & Intens Care Med, Campus Virchow Klinikum, Berlin, Germany; Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Boston, MA USA
hcfmusp.author.externalMATHESON, Matthew B.:Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
hcfmusp.author.externalOSTOVANEH, Mohammad R.:Johns Hopkins Univ Hosp, Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA; Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA
hcfmusp.author.externalCHEN, Marcus Y.:NHLBI, NIH, Lab Cardiac Energet, Bethesda, MD USA
hcfmusp.author.externalPIESKE, Burkert:German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany
hcfmusp.author.externalKOFOED, Klaus F.:Rigshosp, Dept Cardiol, Rigshospitalet, Copenhagen, Denmark
hcfmusp.author.externalSCHUIJF, Joanne D.:Global RDC, Canon Med Syst Europe BV, Zoetermeer, Netherlands
hcfmusp.author.externalNIINUMA, Hiroyuki:Iwate Med Univ, Mem Heart Ctr, Morioka, Japan; St Lukes Int Hosp, Dept Cardiol, Tokyo, Japan
hcfmusp.author.externalDEWEY, Marc:Charite Univ Med Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany; German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany
hcfmusp.author.externalCARLI, Marcelo F. di:German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany
hcfmusp.author.externalCOX, Christopher:Univ Sao Paulo, InCor Heart Inst, Fac Med, Med Sch, Sao Paulo, Brazil
hcfmusp.author.externalLIMA, Joao A. C.:Johns Hopkins Univ Hosp, Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA; Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA
hcfmusp.author.externalARBAB-ZADEH, Armin:Johns Hopkins Univ Hosp, Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA; Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD USA
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcCARLOS EDUARDO ROCHITTE
hcfmusp.description.beginpage310
hcfmusp.description.endpage317
hcfmusp.description.issue5
hcfmusp.description.volume17
hcfmusp.origemWOS
hcfmusp.origem.pubmed37541910
hcfmusp.origem.scopus2-s2.0-85166628928
hcfmusp.origem.wosWOS:001123269600001
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUSAeng
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