Coronary computed tomography plaque-based scores predict long-term cardiovascular events

Area of Science:

• Cardiovascular Imaging
• Radiology
• Preventive Cardiology

Background:

• Coronary computed tomography angiography (coronary CTA) scores assess plaque burden and characteristics for coronary artery disease (CAD) prognostication.
• The long-term prognostic utility of these coronary CTA scores remains incompletely defined.

Purpose of the Study:

• To evaluate the long-term prognosis of coronary CTA scores for predicting major adverse cardiac events (MACE) in symptomatic patients with suspected CAD.

Main Methods:

• Two multicenter prospective studies evaluated CAD extent using coronary CTA and various scores.
• A total of 222 patients were followed for a median of 6.8 years, with 73 experiencing MACE.

Main Results:

• The segment involvement score for non-calcified plaque (SISNoncalc) independently predicted MACE, offering incremental value over clinical data and CAD severity.
• Patients with obstructive CAD and SISNoncalc > 3 had a significantly higher risk of events (HR 4.27).

Conclusions:

• Coronary CTA plaque-based scores provide significant long-term prognostic value for up to 7 years in stable CAD.
• Extensive non-calcified disease (SISNoncalc > 3) in obstructive CAD patients independently predicts late cardiovascular events.