Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification.

Deseive, Simon; Kupke, Maximilian; Straub, Ramona; Stocker, Thomas J; Broersen, Alexander; Kitslaar, Pieter; Martinoff, Stefan; Massberg, Steffen; Hadamitzky, Martin; Hausleiter, Jörg

doi:10.1093/ehjci/jeaa228

User: Guest

journal article

Title:: Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification.
Document type:: Journal Article
Author(s):: Deseive, Simon; Kupke, Maximilian; Straub, Ramona; Stocker, Thomas J; Broersen, Alexander; Kitslaar, Pieter; Martinoff, Stefan; Massberg, Steffen; Hadamitzky, Martin; Hausleiter, Jörg
Abstract:: AIMS: Automated coronary total plaque volume (TPV) quantification derived from coronary computed tomographic angiography (CTA) datasets provide exact and reliable assessment of calcified and non-calcified coronary atherosclerosis burden. The aim of this analysis was to investigate the long-term predictive value of TPV. METHODS AND RESULTS: TPV was quantified in 1577 patients undergoing coronary CTA and cardiovascular events were collected during 10.5 years (interquartile range 6.0-11.4) of follow-up. The study endpoint comprised cardiac death and acute coronary syndrome and occurred in 59 (3.7%) patients. Coronary TPV provided additive prognostic value over clinical risk assessed with the Morise Score and coronary artery disease severity (rise in C-index from 0.744 to 0.769, P = 0.03). A category-based reclassification approach combining the Morise Score and TPV revealed superior risk stratification (categorical net reclassification improvement: 0.48 with 95% CI 0.13-0.68, P < 0.001) and resulted in reclassification of 800 (51%) patients compared with the Morise Score alone. The 10-year risk for the study endpoint was 0.6% (95% CI 0-1.3) for patients classified as low risk (n = 807), 4.8% (95% CI 2.4-7.2) for patients at intermediate risk (n = 400), and 10.3% (95% CI 6.6-13.9) for patients at high risk (n = 370) using the combined reclassification approach. CONCLUSION: Quantification of TPV from coronary CTA permits an improved 10-year cardiovascular risk stratification.
Journal title abbreviation:: Eur Heart J Cardiovasc Imaging
Year:: 2021
Journal volume:: 22
Journal issue:: 3
Pages contribution:: 314-321
Fulltext / DOI:: doi:10.1093/ehjci/jeaa228
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/32793952
Print-ISSN:: 2047-2404
TUM Institution:: Institut für Radiologie und Nuklearmedizin
BibTeX