Data di Pubblicazione:
2018
Citazione:
Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease / S. Lee, J.M. Sung, A. Rizvi, F.Y. Lin, A. Kumar, M. Hadamitzky, Y. Kim, E. Conte, D. Andreini, G. Pontone, M.J. Budoff, I. Gottlieb, B.K. Lee, E.J. Chun, F. Cademartiri, E. Maffei, H. Marques, J.A. Leipsic, S. Shin, J. Hyun Choi, K. Chinnaiyan, G. Raff, R. Virmani, H. Samady, P.H. Stone, D.S. Berman, J. Narula, L.J. Shaw, J.J. Bax, J.K. Min, H. Chang. - In: CIRCULATION. CARDIOVASCULAR IMAGING. - ISSN 1941-9651. - 11:7(2018 Jul), pp. e007562.1-e007562.10. [10.1161/CIRCIMAGING.117.007562]
Abstract:
Background: Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis 50%. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression.Methods and Results: From a 13-center, 7-country prospective observational registry, 1345 patients (60.49.4 years old; 57.1% male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis 50%, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (oPB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with median value of oPB/y (0.33%/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all P<0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all P<0.001). For prediction of adverse outcomes, adding both baseline PB and oPB/y showed best predictive performance (C statistics, 0.763; P<0.001).Conclusions: Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
angiography; atherosclerosis; coronary artery disease; myocardial infarction; risk factors
Elenco autori:
S. Lee, J.M. Sung, A. Rizvi, F.Y. Lin, A. Kumar, M. Hadamitzky, Y. Kim, E. Conte, D. Andreini, G. Pontone, M.J. Budoff, I. Gottlieb, B.K. Lee, E.J. Chun, F. Cademartiri, E. Maffei, H. Marques, J.A. Leipsic, S. Shin, J. Hyun Choi, K. Chinnaiyan, G. Raff, R. Virmani, H. Samady, P.H. Stone, D.S. Berman, J. Narula, L.J. Shaw, J.J. Bax, J.K. Min, H. Chang
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