Tags

Type your tag names separated by a space and hit enter

Quantification of coronary low-attenuation plaque volume for long-term prediction of cardiac events and reclassification of patients.
J Cardiovasc Comput Tomogr. 2018 Mar - Apr; 12(2):118-124.JC

Abstract

BACKGROUND

To investigate the incremental prognostic value of low-attenuation plaque volume (LAPV) from coronary CT angiography datasets.

METHODS

Quantification of LAPV was performed using dedicated software equipped with an adaptive plaque tissue algorithm in 1577 patients with suspected CAD. A combination of death and acute coronary syndrome was defined as primary endpoint. To assess the incremental prognostic value of LAPV, parameters were added to a baseline model including clinical risk and obstructive coronary artery disease (CAD), a baseline model including clinical risk and calcium scoring (CACS) and a baseline model including clinical risk and segment involvement score (SIS).

RESULTS

Patients were followed for 5.5 years either by telephone contact, mail or clinical visits. The primary endpoint occurred in 30 patients. Quantified LAPV provided incremental prognostic information beyond clinical risk and obstructive CAD (c-index 0.701 vs. 0.767, p < .001), clinical risk and CACS (c-index 0.722 vs. 0.771, p < .01) and clinical risk and SIS (c-index 0.735 vs. 0.771, p < .01. A combined approach using quantified LAPV and clinical risk significantly improved the stratification of patients into different risk categories compared to clinical risk alone (categorical net reclassification index 0.69 with 95% CI 0.27 and 0.96, p < .001). The combined approach classified 846 (53.6%) patients as low risk (annual event rate 0.04%), 439 (27.8%) patients as intermediate risk (annual event rate 0.5%) and 292 (18.5%) patients as high risk (annual event rate 0.99%).

CONCLUSION

Quantification of LAPV provides incremental prognostic information beyond established CT risk patterns and permits improved stratification of patients into different risk categories.

Authors+Show Affiliations

Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: simon.deseive@med.uni-muenchen.de.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Medis Medical Imaging Systems Bv, Leiden, The Netherlands.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.Division of Radiology, Deutsches Herzzentrum Muenchen, Munich, Germany.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29398567

Citation

Deseive, S, et al. "Quantification of Coronary Low-attenuation Plaque Volume for Long-term Prediction of Cardiac Events and Reclassification of Patients." Journal of Cardiovascular Computed Tomography, vol. 12, no. 2, 2018, pp. 118-124.
Deseive S, Straub R, Kupke M, et al. Quantification of coronary low-attenuation plaque volume for long-term prediction of cardiac events and reclassification of patients. J Cardiovasc Comput Tomogr. 2018;12(2):118-124.
Deseive, S., Straub, R., Kupke, M., Broersen, A., Kitslaar, P. H., Massberg, S., Hadamitzky, M., & Hausleiter, J. (2018). Quantification of coronary low-attenuation plaque volume for long-term prediction of cardiac events and reclassification of patients. Journal of Cardiovascular Computed Tomography, 12(2), 118-124. https://doi.org/10.1016/j.jcct.2018.01.002
Deseive S, et al. Quantification of Coronary Low-attenuation Plaque Volume for Long-term Prediction of Cardiac Events and Reclassification of Patients. J Cardiovasc Comput Tomogr. 2018 Mar - Apr;12(2):118-124. PubMed PMID: 29398567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantification of coronary low-attenuation plaque volume for long-term prediction of cardiac events and reclassification of patients. AU - Deseive,S, AU - Straub,R, AU - Kupke,M, AU - Broersen,A, AU - Kitslaar,P H, AU - Massberg,S, AU - Hadamitzky,M, AU - Hausleiter,J, Y1 - 2018/01/06/ PY - 2017/10/28/received PY - 2017/12/23/revised PY - 2018/01/05/accepted PY - 2018/2/6/pubmed PY - 2018/8/28/medline PY - 2018/2/6/entrez KW - Coronary CT angiography KW - Coronary plaque volume KW - Low-attenuation plaque volume KW - Plaque volume quantification KW - Prognosis SP - 118 EP - 124 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 12 IS - 2 N2 - BACKGROUND: To investigate the incremental prognostic value of low-attenuation plaque volume (LAPV) from coronary CT angiography datasets. METHODS: Quantification of LAPV was performed using dedicated software equipped with an adaptive plaque tissue algorithm in 1577 patients with suspected CAD. A combination of death and acute coronary syndrome was defined as primary endpoint. To assess the incremental prognostic value of LAPV, parameters were added to a baseline model including clinical risk and obstructive coronary artery disease (CAD), a baseline model including clinical risk and calcium scoring (CACS) and a baseline model including clinical risk and segment involvement score (SIS). RESULTS: Patients were followed for 5.5 years either by telephone contact, mail or clinical visits. The primary endpoint occurred in 30 patients. Quantified LAPV provided incremental prognostic information beyond clinical risk and obstructive CAD (c-index 0.701 vs. 0.767, p < .001), clinical risk and CACS (c-index 0.722 vs. 0.771, p < .01) and clinical risk and SIS (c-index 0.735 vs. 0.771, p < .01. A combined approach using quantified LAPV and clinical risk significantly improved the stratification of patients into different risk categories compared to clinical risk alone (categorical net reclassification index 0.69 with 95% CI 0.27 and 0.96, p < .001). The combined approach classified 846 (53.6%) patients as low risk (annual event rate 0.04%), 439 (27.8%) patients as intermediate risk (annual event rate 0.5%) and 292 (18.5%) patients as high risk (annual event rate 0.99%). CONCLUSION: Quantification of LAPV provides incremental prognostic information beyond established CT risk patterns and permits improved stratification of patients into different risk categories. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/29398567/Quantification_of_coronary_low_attenuation_plaque_volume_for_long_term_prediction_of_cardiac_events_and_reclassification_of_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(18)30011-X DB - PRIME DP - Unbound Medicine ER -