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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary Atherosclerosis Progression Provides Incremental Prognostic Value and Optimizes Risk Reclassification by
Qingchao Meng1, Yunqiang An, Li Zhao
1Department of Radiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China.
Coronary atherosclerosis progression assessed by serial coronary computed tomography angiography (CCTA) improves prediction of major adverse cardiovascular events (MACE). This method offers better risk stratification than baseline factors alone.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) management relies on accurate risk stratification.
- Serial coronary computed tomography angiography (CCTA) offers serial assessment of coronary atherosclerosis.
- The prognostic value of tracking atherosclerosis progression remains an area of active investigation.
Purpose of the Study:
- To evaluate the prognostic capability of coronary atherosclerosis progression using serial CCTA.
- To assess the risk reclassification ability of models incorporating atherosclerosis progression.
- To compare the predictive performance of different risk models for major adverse cardiovascular events (MACE).
Main Methods:
- Patients with suspected or confirmed CAD undergoing serial CCTA were enrolled.
- Coronary atherosclerosis progression was quantified using changes in coronary artery calcium score (CACS) and segment stenosis score (SSS).
- Three risk models were compared: baseline factors, baseline factors + SSS, and baseline factors + SSS + SSS progression.
Main Results:
- A total of 516 patients were followed for a mean of 65.29 months, with 114 MACE occurring.
- Higher baseline and follow-up CACS and SSS, along with greater atherosclerosis progression (ΔSSS, ΔCACS), were observed in the MACE group.
- Segment stenosis score (SSS) progression significantly improved prognostic information (C-index) and risk reclassification (NRI) compared to models without it.
Conclusions:
- Coronary atherosclerosis progression assessed via serial CCTA provides significant incremental prognostic value for MACE.
- Tracking atherosclerosis progression enhances risk stratification beyond baseline factors and single CCTA assessments.
- Serial CCTA is a valuable tool for improving cardiovascular risk prediction in patients with CAD.
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