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Additive prognostic value of coronary artery calcium score over coronary computed tomographic angiography stenosis assessment in symptomatic patients without known coronary artery disease.
Am J Cardiol. 2015 Mar 15; 115(6):738-44.AJ

Abstract

The objective of this study was to examine the additive prognostic performance of coronary artery calcium score (CACS) over coronary computed tomography angiography (CCTA) stenosis assessment in symptomatic patients suspected for coronary artery disease (CAD) undergoing CCTA. A total of 805 symptomatic patients without known history of CAD who underwent coronary evaluation by multidetector cardiac CT were analyzed. Mean age of the cohort was 58 ± 13 years. A total of 44% (354 of 805) of the patients had a 0 CACS, 27% (215 of 805) had CACS 1 to 100, 14% (111 of 805) had CACS 101 to 400, and 15% (125 of 805) had CACS >400. CCTA showed normal coronary arteries in 43% (349 of 805) of patients, ≤50% stenosis in 42% (333 of 805), and >50% stenosis in 15% (123 of 805). Patients were followed for 2.3 ± 0.9 years. Major adverse cardiac event (MACE) was defined as cardiac death, nonfatal myocardial infarction, and late coronary revascularization. Overall incidence of MACE was 1.4% per year. Both CACS and CCTA stenosis were independently associated with increased MACE (p <0.05 for both). Addition of CACS into the model with clinical risk factors and CCTA stenosis significantly improved predictive performance for MACE from the model with clinical risk factors and CCTA stenosis only (global chi-square score 108 vs 70; p = 0.019). In conclusion; in symptomatic patients without known CAD, both CACS and CCTA stenosis were independently associated with increased cardiac events, and performing non-contrast-enhanced CACS evaluation in addition to contrast-enhanced CCTA improved predictive ability for future cardiac events compared to CCTA stenosis assessment alone.

Authors+Show Affiliations

Department of Medicine, Houston Methodist Hospital, Houston, Texas. Electronic address: kchaikriangkrai@houstonmethodist.org.Department of Medicine, Houston Methodist Hospital, Houston, Texas.Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

25604930

Citation

Chaikriangkrai, Kongkiat, et al. "Additive Prognostic Value of Coronary Artery Calcium Score Over Coronary Computed Tomographic Angiography Stenosis Assessment in Symptomatic Patients Without Known Coronary Artery Disease." The American Journal of Cardiology, vol. 115, no. 6, 2015, pp. 738-44.
Chaikriangkrai K, Velankar P, Schutt R, et al. Additive prognostic value of coronary artery calcium score over coronary computed tomographic angiography stenosis assessment in symptomatic patients without known coronary artery disease. Am J Cardiol. 2015;115(6):738-44.
Chaikriangkrai, K., Velankar, P., Schutt, R., Alchalabi, S., Nabi, F., Mahmarian, J., & Chang, S. M. (2015). Additive prognostic value of coronary artery calcium score over coronary computed tomographic angiography stenosis assessment in symptomatic patients without known coronary artery disease. The American Journal of Cardiology, 115(6), 738-44. https://doi.org/10.1016/j.amjcard.2014.12.032
Chaikriangkrai K, et al. Additive Prognostic Value of Coronary Artery Calcium Score Over Coronary Computed Tomographic Angiography Stenosis Assessment in Symptomatic Patients Without Known Coronary Artery Disease. Am J Cardiol. 2015 Mar 15;115(6):738-44. PubMed PMID: 25604930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additive prognostic value of coronary artery calcium score over coronary computed tomographic angiography stenosis assessment in symptomatic patients without known coronary artery disease. AU - Chaikriangkrai,Kongkiat, AU - Velankar,Pradnya, AU - Schutt,Robert, AU - Alchalabi,Sama, AU - Nabi,Faisal, AU - Mahmarian,John, AU - Chang,Su Min, Y1 - 2015/01/06/ PY - 2014/11/13/received PY - 2014/12/23/revised PY - 2014/12/23/accepted PY - 2015/1/22/entrez PY - 2015/1/22/pubmed PY - 2015/5/16/medline SP - 738 EP - 44 JF - The American journal of cardiology JO - Am J Cardiol VL - 115 IS - 6 N2 - The objective of this study was to examine the additive prognostic performance of coronary artery calcium score (CACS) over coronary computed tomography angiography (CCTA) stenosis assessment in symptomatic patients suspected for coronary artery disease (CAD) undergoing CCTA. A total of 805 symptomatic patients without known history of CAD who underwent coronary evaluation by multidetector cardiac CT were analyzed. Mean age of the cohort was 58 ± 13 years. A total of 44% (354 of 805) of the patients had a 0 CACS, 27% (215 of 805) had CACS 1 to 100, 14% (111 of 805) had CACS 101 to 400, and 15% (125 of 805) had CACS >400. CCTA showed normal coronary arteries in 43% (349 of 805) of patients, ≤50% stenosis in 42% (333 of 805), and >50% stenosis in 15% (123 of 805). Patients were followed for 2.3 ± 0.9 years. Major adverse cardiac event (MACE) was defined as cardiac death, nonfatal myocardial infarction, and late coronary revascularization. Overall incidence of MACE was 1.4% per year. Both CACS and CCTA stenosis were independently associated with increased MACE (p <0.05 for both). Addition of CACS into the model with clinical risk factors and CCTA stenosis significantly improved predictive performance for MACE from the model with clinical risk factors and CCTA stenosis only (global chi-square score 108 vs 70; p = 0.019). In conclusion; in symptomatic patients without known CAD, both CACS and CCTA stenosis were independently associated with increased cardiac events, and performing non-contrast-enhanced CACS evaluation in addition to contrast-enhanced CCTA improved predictive ability for future cardiac events compared to CCTA stenosis assessment alone. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/25604930/Additive_prognostic_value_of_coronary_artery_calcium_score_over_coronary_computed_tomographic_angiography_stenosis_assessment_in_symptomatic_patients_without_known_coronary_artery_disease_ DB - PRIME DP - Unbound Medicine ER -