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Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization.
J Am Heart Assoc. 2015 Aug 21; 4(8):e002264.JA

Abstract

BACKGROUND

Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment.

METHODS AND RESULTS

Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell's C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%).

CONCLUSIONS

High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization.

Authors+Show Affiliations

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.) Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA (K.K.K., F.J.R.).Department of Biostatistics, School of Public Health, The University of Tokyo, Japan (T.S.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.) Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA (K.K.K., F.J.R.).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26296858

Citation

Fujimoto, Shinichiro, et al. "Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization." Journal of the American Heart Association, vol. 4, no. 8, 2015, pp. e002264.
Fujimoto S, Kondo T, Kumamaru KK, et al. Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization. J Am Heart Assoc. 2015;4(8):e002264.
Fujimoto, S., Kondo, T., Kumamaru, K. K., Shinozaki, T., Takamura, K., Kawaguchi, Y., Matsumori, R., Hiki, M., Miyauchi, K., Daida, H., & Rybicki, F. J. (2015). Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization. Journal of the American Heart Association, 4(8), e002264. https://doi.org/10.1161/JAHA.115.002264
Fujimoto S, et al. Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization. J Am Heart Assoc. 2015 Aug 21;4(8):e002264. PubMed PMID: 26296858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization. AU - Fujimoto,Shinichiro, AU - Kondo,Takeshi, AU - Kumamaru,Kanako K, AU - Shinozaki,Tomohiro, AU - Takamura,Kazuhisa, AU - Kawaguchi,Yuko, AU - Matsumori,Rie, AU - Hiki,Makoto, AU - Miyauchi,Katsumi, AU - Daida,Hiroyuki, AU - Rybicki,Frank J, Y1 - 2015/08/21/ PY - 2015/8/23/entrez PY - 2015/8/25/pubmed PY - 2016/5/5/medline KW - computed tomography–high risk plaque KW - coronary artery calcium score KW - coronary computed tomography angiography KW - coronary revascularization KW - prognostic value SP - e002264 EP - e002264 JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 4 IS - 8 N2 - BACKGROUND: Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. METHODS AND RESULTS: Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell's C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). CONCLUSIONS: High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/26296858/Prognostic_Value_of_Coronary_Computed_Tomography__CT__Angiography_and_Coronary_Artery_Calcium_Score_Performed_Before_Revascularization_ L2 - https://www.ahajournals.org/doi/10.1161/JAHA.115.002264?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -