Related Experiment Video

Updated: Jul 20, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.3K

Coronary artery disease grading by cardiac CT for predicting outcome in patients with stable angina

Christian U Oeing1, Matthew B Matheson2, Mohammad R Ostovaneh3

  • 1Johns Hopkins Hospital and School of Medicine, 600 N Wolfe St, Blalock 524, Baltimore, MD, USA; Deutsches Herzzentrum der Charité (DHZC), Charité - Universitätsmedizin Berlin, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow-Klinikum, Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.

Journal of Cardiovascular Computed Tomography
|August 4, 2023
PubMed

Insights

For patients with suspected coronary heart disease (CHD), a history of CHD is the strongest predictor of major adverse cardiovascular events (MACE). In those without prior CHD, coronary calcium scoring offers effective risk stratification.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary atheroma burden is a key driver of major adverse cardiovascular events (MACE) in patients with suspected coronary heart disease (CHD).
  • Current methods for grading coronary heart disease burden lack consensus for effective risk stratification.
  • This study aimed to compare the efficacy of common CHD grading tools for symptomatic patients.

Purpose of the Study:

  • To evaluate and compare the effectiveness of various coronary heart disease (CHD) grading tools in risk stratifying symptomatic patients.
  • To determine the best predictors of major adverse cardiovascular events (MACE) in patients with suspected CHD.

Main Methods:

  • Analysis of 5-year outcomes in 381 patients from the CORE320 multicenter study.
  • Utilized baseline clinical data and cardiac CT imaging including coronary artery calcium score (CACS), percent atheroma volume, high-risk plaque, CAD-RADS, and simplified staging systems.
  • Applied Cox proportional hazard models and AUC analysis to predict MACE, stratified by CHD history.

Main Results:

  • Clinical characteristics were the strongest MACE predictors in the overall cohort.
  • In patients without prior CHD, CACS was the sole independent MACE predictor (AUC 73%), outperforming clinical characteristics (AUC 64%).
  • Simple CHD grading schemes demonstrated similar risk stratification to CAD-RADS; noncalcified plaque volume offered no additional prognostic value.

Conclusions:

  • A history of CHD is the most significant predictor of MACE in patients undergoing invasive angiography.
  • For patients without a history of CHD, coronary calcium scoring provides risk stratification comparable to more complex grading methods.
Abstract

Keywords:
AnginaCTCoronary atherosclerosisCoronary heart diseaseCoronary imaging

More Related Videos

Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection06:57

Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection

Published on: September 22, 2023

1.0K
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

456

Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
39
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
42
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
10
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
7
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
20