Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification

Deseive, Simon; Kupke, Maximilian; Straub, Ramona; Stocker, Thomas J.; Broersen, Alexander; Kitslaar, Pieter; Martinoff, Stefan; Massberg, Steffen; Hadamitzky, Martin und Hausleiter, Joerg (2021): Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification. In: European Heart Journal-Cardiovascular Imaging, Bd. 22, Nr. 3: S. 314-321

Abstract

Aims Automated coronary total plaque volume (TPV) quantification derived from coronary computed tomographic angiography (CTA) datasets provide exact and reliable assessment of calcified and non-calcified coronary atheroscler- osis burden. The aim of this analysis was to investigate the long-term predictive value of TPV. Methods and results TPV was quantified in 1577 patients undergoing coronary CTA and cardiovascular events were collected during 10.5 years (interquartile range 6.0-11.4) of follow-up. The study endpoint comprised cardiac death and acute cor- onary syndrome and occurred in 59 (3.7%) patients. Coronary TPV provided additive prognostic value over clinical risk assessed with the Morise Score and coronary artery disease severity (rise in C-index from 0.744 to 0.769, P=0.03). A category-based reclassification approach combining the Morise Score and TPV revealed superior risk stratification (categorical net reclassification improvement: 0.48 with 95% CI 0.13-0.68, P< 0.001) and resulted in reclassification of 800 (51%) patients compared with the Morise Score alone. The 10-year risk for the study endpoint was 0.6% (95% CI 0-1.3) for patients classified as low risk (n = 807), 4.8% (95% CI 2.4-7.2) for patients at intermediate risk (n = 400), and 10.3% (95% CI 6.6-13.9) for patients at high risk (n = 370) using the combined reclassification approach. Conclusion Quantification of TPV from coronary CTA permits an improved 10-year cardiovascular risk stratification.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2047-2404
• Sprache: Englisch