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Title:

Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease.

Document type:
Journal Article
Author(s):
Lee, Sang-Eun; Sung, Ji Min; Rizvi, Asim; Lin, Fay Y; Kumar, Amit; Hadamitzky, Martin; Kim, Yong-Jin; Conte, Edoardo; Andreini, Daniele; Pontone, Gianluca; Budoff, Matthew J; Gottlieb, Ilan; Lee, Byoung Kwon; Chun, Eun Ju; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Leipsic, Jonathon A; Shin, Sanghoon; Hyun Choi, Jung; Chinnaiyan, Kavitha; Raff, Gilbert; Virmani, Renu; Samady, Habib; Stone, Peter H; Berman, Daniel S; Narula, Jagat; Shaw, Leslee J; Bax, Jeroen J; Min, James K; Chang, Hyuk...     »
Abstract:
Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis >=50%. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression.From a 13-center, 7-country prospective observational registry, 1345 patients (60.4±9.4 years old; 57.1% male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis >=50%, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (?PB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with >=median value of ?PB/y (0.33%/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all <0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all <0.001). For prediction of adverse outcomes, adding both baseline PB and ?PB/y showed best predictive performance (C statistics, 0.763; <0.001).Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease.URL: https://www.clinicaltrials.gov. Unique identifier: NCT02803411.
Journal title abbreviation:
Circ Cardiovasc Imaging
Year:
2018
Journal volume:
11
Journal issue:
7
Pages contribution:
e007562
Language:
eng
Fulltext / DOI:
doi:10.1161/CIRCIMAGING.117.007562
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/30012825
Print-ISSN:
1941-9651
TUM Institution:
Institut für Radiologie
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