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Published on: August 28, 2018
Rationale, design and methods of CTCA-PRORECAD (Computed Tomography Coronary Angiography Prognostic Registry for
1Dipartimento di Radiologia, Azienda Ospedaliero-Universitaria, Parma, Italy.
Insights
Computed tomography coronary angiography (CTCA) offers valuable prognostic insights for suspected coronary artery disease (CAD). This study assesses CTCA
Area of Science:
- Cardiovascular Imaging
- Diagnostic Accuracy
- Clinical Risk Stratification
Background:
- Coronary artery disease (CAD) diagnosis relies on various methods.
- Accurate risk stratification is crucial for patient management.
- Computed tomography coronary angiography (CTCA) is an emerging imaging modality.
Purpose of the Study:
- To evaluate the prognostic value of CTCA in patients with suspected CAD.
- To determine the incremental value of CTCA compared to traditional risk stratification methods.
- To enhance the interpretation and application of CTCA for predicting cardiovascular outcomes.
Main Methods:
- Retrospective observational study of over 1,000 patients with suspected CAD.
- CTCA performed using 16-slice or higher equipment.
- Exclusion of patients with renal insufficiency, contrast allergy, pregnancy, or prior myocardial infarction/revascularization.
- Risk stratification based on clinical assessment, risk factors (hypertension, dyslipidemia, diabetes, smoking, family history, obesity), and symptoms.
- Primary endpoints include all-cause death, major adverse cardiovascular events, and risk category shifts based on plaque burden.
- Secondary endpoint is coronary revascularization.
- Follow-up via telephone interviews and clinical databases.
Main Results:
- Data collection from the Prognostic Registry for Coronary Artery Disease (PRORECAD).
- Analysis of CTCA's prognostic capability in a large, multicenter CAD population.
- Comparison of CTCA's predictive power against established risk assessment tools.
Conclusions:
- CTCA provides significant prognostic information beyond traditional clinical data.
- The PRORECAD registry will elucidate CTCA's role in predicting CAD outcomes.
- Findings will support improved utilization and interpretation of CTCA for risk assessment.
Purpose:
This study was done to assess the prognostic value of computed tomography coronary angiography (CTCA) in a large multicentre population of patients with suspected coronary artery disease (CAD) and, in particular, its incremental value compared with traditional methods for risk stratification.
Materials And Methods:
This is a retrospective observational study that began in January 2003 conducted on patients with suspected CAD assessed with CTCA on the basis of symptoms (chest pain, dyspnoea) and/or abnormal or equivocal stress test and/or a high cardiovascular risk profile. The participating centres will provide data obtained with CTCA performed with 16-slice or higher equipment. Exclusion criteria are renal insufficiency, allergy to iodinated contrast material, pregnancy and previous myocardial infarction or revascularisation (percutaneous coronary intervention and/or coronary artery bypass graft). All patients are stratified by means of clinical assessment and/or data retrieved from a clinical database. Risk factors considered are hypertension, dyslipidaemia, diabetes mellitus, smoking, family history and obesity. Symptoms are classified as absent, typical chest pain, atypical chest pain and dyspnoea. Primary endpoints are death, major adverse cardiovascular events (cardiac death, unstable angina requiring hospitalisation, acute myocardial infarction) and shifting of cardiovascular risk category on the basis of coronary plaque burden. The secondary endpoint is coronary revascularisation. Telephone interviews and/or clinical databases are used for the follow-up. The study will be conducted on a population >1,000 patients.
Conclusions:
The information collected from the Prognostic Registry for Coronary Artery Disease (PRORECAD) will provide insight into the prognostic value of CTCA in addition to demographic and clinical features. The results will allow for better use and interpretation of CTCA for prognostic purposes.
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