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Calcification remodeling index assessed by cardiac CT predicts severe coronary stenosis in lesions with moderate to severe calcification.
J Cardiovasc Comput Tomogr. 2018 Jan - Feb; 12(1):42-49.JC

Abstract

OBJECTIVES

To assess the diagnostic performance of the calcification remodeling index (RI) as assessed by coronary computed tomography angiography (coronary CTA) to predict the presence of severe coronary stenosis in atherosclerotic coronary lesions with moderate to severe calcification.

METHODS

Patients who underwent coronary CTA and invasive coronary angiography (ICA) within one month and had moderately to severely calcified lesions as revealed by coronary CTA, were retrospectively included. The calcification RI was calculated as the ratio of the cross-sectional lumen area (with inclusion of calcium area) of the most severely calcified site to the proximal reference lumen area. Other parameters, such as the calcium volume, regional Agatston score, calcification length, involved calcium arc quadrants and CTA-assessed diameter stenosis, were also recorded. A multivariate model was used to identify the variables that predict the presence of severe coronary stenosis (diameter stenosis ≧ 70%) as determined by ICA.

RESULTS

422 patients with 629 lesions were finally included in the study. Lesions with severe stenoses as determined by ICA tended to have larger calcium volumes, regional Agatston scores, CTA-assessed diameter stenoses, longer calcium length, more involved calcium arc quadrants and a significantly smaller calcification remodeling index. ROC curve analysis determined the best cutoff value of the calcification RI as 0.94 (AUC = 0.816, p < 0.001), which yielded highest diagnostic accuracy (83.3%, 524/629) to identify severe coronary stenosis. Among all parameters, calcification RI ≦0.94 is the strongest independent predictor (odds ratio: 17.5, p < 0.001) of severe coronary stenosis.

CONCLUSIONS

With an optimalcut-off value of 0.94, calcification RI is the strongest independent predictor of severe coronary stenosis in calcified coronary atherosclerotic lesions.

Authors+Show Affiliations

Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: dryumengmeng@126.com.Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: drliyuehua@126.com.Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: drliwenbin@126.com.Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: drluzhigang@126.com.Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: drmengwei@126.com.Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. Electronic address: andrewssmu@msn.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28988831

Citation

Yu, Mengmeng, et al. "Calcification Remodeling Index Assessed By Cardiac CT Predicts Severe Coronary Stenosis in Lesions With Moderate to Severe Calcification." Journal of Cardiovascular Computed Tomography, vol. 12, no. 1, 2018, pp. 42-49.
Yu M, Li Y, Li W, et al. Calcification remodeling index assessed by cardiac CT predicts severe coronary stenosis in lesions with moderate to severe calcification. J Cardiovasc Comput Tomogr. 2018;12(1):42-49.
Yu, M., Li, Y., Li, W., Lu, Z., Wei, M., & Zhang, J. (2018). Calcification remodeling index assessed by cardiac CT predicts severe coronary stenosis in lesions with moderate to severe calcification. Journal of Cardiovascular Computed Tomography, 12(1), 42-49. https://doi.org/10.1016/j.jcct.2017.09.017
Yu M, et al. Calcification Remodeling Index Assessed By Cardiac CT Predicts Severe Coronary Stenosis in Lesions With Moderate to Severe Calcification. J Cardiovasc Comput Tomogr. 2018 Jan - Feb;12(1):42-49. PubMed PMID: 28988831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcification remodeling index assessed by cardiac CT predicts severe coronary stenosis in lesions with moderate to severe calcification. AU - Yu,Mengmeng, AU - Li,Yuehua, AU - Li,Wenbin, AU - Lu,Zhigang, AU - Wei,Meng, AU - Zhang,Jiayin, Y1 - 2017/09/30/ PY - 2017/05/08/received PY - 2017/08/25/revised PY - 2017/09/27/accepted PY - 2017/10/11/pubmed PY - 2018/8/28/medline PY - 2017/10/10/entrez KW - Angiography KW - Calcification KW - Computed tomography KW - Coronary KW - Remodeling index SP - 42 EP - 49 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 12 IS - 1 N2 - OBJECTIVES: To assess the diagnostic performance of the calcification remodeling index (RI) as assessed by coronary computed tomography angiography (coronary CTA) to predict the presence of severe coronary stenosis in atherosclerotic coronary lesions with moderate to severe calcification. METHODS: Patients who underwent coronary CTA and invasive coronary angiography (ICA) within one month and had moderately to severely calcified lesions as revealed by coronary CTA, were retrospectively included. The calcification RI was calculated as the ratio of the cross-sectional lumen area (with inclusion of calcium area) of the most severely calcified site to the proximal reference lumen area. Other parameters, such as the calcium volume, regional Agatston score, calcification length, involved calcium arc quadrants and CTA-assessed diameter stenosis, were also recorded. A multivariate model was used to identify the variables that predict the presence of severe coronary stenosis (diameter stenosis ≧ 70%) as determined by ICA. RESULTS: 422 patients with 629 lesions were finally included in the study. Lesions with severe stenoses as determined by ICA tended to have larger calcium volumes, regional Agatston scores, CTA-assessed diameter stenoses, longer calcium length, more involved calcium arc quadrants and a significantly smaller calcification remodeling index. ROC curve analysis determined the best cutoff value of the calcification RI as 0.94 (AUC = 0.816, p < 0.001), which yielded highest diagnostic accuracy (83.3%, 524/629) to identify severe coronary stenosis. Among all parameters, calcification RI ≦0.94 is the strongest independent predictor (odds ratio: 17.5, p < 0.001) of severe coronary stenosis. CONCLUSIONS: With an optimalcut-off value of 0.94, calcification RI is the strongest independent predictor of severe coronary stenosis in calcified coronary atherosclerotic lesions. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/28988831/Calcification_remodeling_index_assessed_by_cardiac_CT_predicts_severe_coronary_stenosis_in_lesions_with_moderate_to_severe_calcification_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(17)30219-8 DB - PRIME DP - Unbound Medicine ER -