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Prognostic Value of Coronary Computed Tomography Angiography-derived Morphologic and Quantitative Plaque Markers

Stefan Baumann1,2, Finja Kaeder1,2, U Joseph Schoepf3

  • 1First Department of Medicine-Cardiology, University Medical Centre Mannheim.

Journal of Thoracic Imaging
|April 7, 2020
PubMed

Insights

Coronary computed tomography angiography plaque markers and risk scores effectively predict major adverse cardiovascular events (MACE). These tools aid in identifying patients at high risk for future cardiac events, improving patient management.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Radiology

Background:

  • Accurate risk stratification for major adverse cardiovascular events (MACE) is crucial in managing patients with suspected coronary artery disease (CAD).
  • Coronary computed tomography angiography (CCTA) offers detailed visualization of coronary anatomy and plaque characteristics.
  • Identifying reliable prognostic markers from CCTA is essential for optimizing patient care and preventing adverse cardiac events.

Purpose of the Study:

  • To evaluate the prognostic value of CCTA-derived morphologic and quantitative plaque markers and risk scores for predicting MACE.
  • To assess the predictive performance of various plaque characteristics and established risk scores in patients with suspected CAD.

Main Methods:

  • Analysis of data from 131 patients with suspected CAD undergoing CCTA.
  • Semiautomated software was used to derive plaque markers, including total plaque volume and percentage aggregated plaque volume.
  • Calculation of several risk scores (e.g., CAD-Reporting and Data System, SYNTAX score, Leiden-risk score) and collection of follow-up data for MACE.

Main Results:

  • Eleven MACE occurred during a mean follow-up of 34 months.
  • Significant predictors for MACE included CAD-Reporting and Data System score (OR=11.62), SYNTAX score (SS) (OR=1.11), Leiden-risk score (OR=1.37), segment involvement score (OR=1.76), total plaque volume (OR=1.20), and percentage aggregated plaque volume (OR=1.32) (all P≤0.05).
  • The difference of corrected coronary opacification (ΔCCO) also significantly correlated with MACE (P<0.0001), demonstrating high sensitivity and specificity for risk prediction.

Conclusions:

  • CCTA-derived plaque markers (segment involvement score, total plaque volume, percentage aggregated plaque volume, ΔCCO) and risk scores possess significant prognostic value for MACE.
  • These quantitative and morphologic markers can effectively aid in identifying patients at elevated risk for future cardiac events.
  • Integration of these CCTA-derived insights can enhance clinical decision-making for patients with suspected CAD.
Abstract

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