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Measuring progression and regression of coronary atherosclerosis in clinical trials: problems and progress

J Lespérance1, D Waters

  • 1Department of Radiology, University of Montreal Medical School, Quebec, Canada.

International Journal of Cardiac Imaging
|January 1, 1992
PubMed

Insights

Quantitative coronary arteriography is essential for clinical trials evaluating coronary atherosclerosis interventions. Two systems, CAAS and CMS, show reliable measurements, with CMS tracking arterial edges more precisely.

Area of Science:

  • Cardiovascular research
  • Medical imaging analysis

Background:

  • Clinical trials for coronary atherosclerosis often use coronary events as endpoints, which is time-consuming.
  • Quantitative coronary arteriography (QCA) offers a more efficient method using precise measurements of coronary artery dimensions.

Purpose of the Study:

  • To assess the variability of two quantitative coronary arteriography systems: Cardiovascular Angiographic Analysis System (CAAS) and Cardiovascular Measurement System (CMS).
  • To determine the reliability of these systems for measuring changes in coronary artery dimensions in clinical trials.

Main Methods:

  • Variability of CAAS and CMS was tested on 54 lesions under four conditions, ranging from optimal to realistic clinical settings (different films, varying time intervals).
  • Measurements of minimum diameter were analyzed for reproducibility and differences between systems.

Main Results:

  • Repeat measurement variability increased with less optimal conditions for both CAAS (0.088 mm to 0.197 mm) and CMS (0.087 mm to 0.240 mm).
  • No statistically significant differences were found between CAAS and CMS in minimum diameter measurements.
  • CMS demonstrated more meticulous tracking of the arterial edge compared to CAAS.

Conclusions:

  • Quantitative coronary arteriography is a crucial tool for clinical trials assessing interventions on coronary atherosclerosis.
  • A change of ≥0.4 mm (CAAS) or ≥0.48 mm (CMS) in minimum diameter indicates a true progression or regression with >95% probability.

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