Progression of non-obstructive coronary plaque: a practical CCTA-based risk score from the PARADIGM registry.
Computed tomography angiography
Coronary artery disease
Disease progression
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
18
09
2022
accepted:
14
04
2023
revised:
27
03
2023
pubmed:
26
9
2023
medline:
26
9
2023
entrez:
26
9
2023
Statut:
ppublish
Résumé
No clear recommendations are endorsed by the different scientific societies on the clinical use of repeat coronary computed tomography angiography (CCTA) in patients with non-obstructive coronary artery disease (CAD). This study aimed to develop and validate a practical CCTA risk score to predict medium-term disease progression in patients at a low-to-intermediate probability of CAD. Patients were part of the Progression of AtheRosclerotic PlAque Determined by Computed Tomographic Angiography Imaging (PARADIGM) registry. Specifically, 370 (derivation cohort) and 219 (validation cohort) patients with two repeat, clinically indicated CCTA scans, non-obstructive CAD, and absence of high-risk plaque (≥ 2 high-risk features) at baseline CCTA were included. Disease progression was defined as the new occurrence of ≥ 50% stenosis and/or high-risk plaque at follow-up CCTA. In the derivation cohort, 104 (28%) patients experienced disease progression. The median time interval between the two CCTAs was 3.3 years (2.7-4.8). Odds ratios for disease progression derived from multivariable logistic regression were as follows: 4.59 (95% confidence interval: 1.69-12.48) for the number of plaques with spotty calcification, 3.73 (1.46-9.52) for the number of plaques with low attenuation component, 2.71 (1.62-4.50) for 25-49% stenosis severity, 1.47 (1.17-1.84) for the number of bifurcation plaques, and 1.21 (1.02-1.42) for the time between the two CCTAs. The C-statistics of the model were 0.732 (0.676-0.788) and 0.668 (0.583-0.752) in the derivation and validation cohorts, respectively. The new CCTA-based risk score is a simple and practical tool that can predict mid-term CAD progression in patients with known non-obstructive CAD. The clinical implementation of this new CCTA-based risk score can help promote the management of patients with non-obstructive coronary disease in terms of timing of imaging follow-up and therapeutic strategies. • No recommendations are available on the use of repeat CCTA in patients with non-obstructive CAD. • This new CCTA score predicts mid-term CAD progression in patients with non-obstructive stenosis at baseline. • This new CCTA score can help guide the clinical management of patients with non-obstructive CAD.
Identifiants
pubmed: 37750979
doi: 10.1007/s00330-023-09880-x
pii: 10.1007/s00330-023-09880-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2665-2676Subventions
Organisme : National Research Foundation funded by the Ministry of Science and Information and Communications Technology of Korea
ID : 2012027176
Informations de copyright
© 2023. The Author(s), under exclusive licence to European Society of Radiology.
Références
Dagenais GR, Leong DP, Rangarajan S et al (2020) Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. Lancet 395:785–794
doi: 10.1016/S0140-6736(19)32007-0
pubmed: 31492501
Investigators S-H, Newby DE, Adamson PD et al (2018) Coronary CT angiography and 5-year risk of myocardial infarction. N Engl J Med 379:924–933
doi: 10.1056/NEJMoa1805971
Franco M, Cooper RS, Bilal U, Fuster V (2011) Challenges and opportunities for cardiovascular disease prevention. Am J Med 124:95–102
doi: 10.1016/j.amjmed.2010.08.015
pubmed: 21295188
Al-Mallah MH, Qureshi W, Lin FY et al (2014) Does coronary CT angiography improve risk stratification over coronary calcium scoring in symptomatic patients with suspected coronary artery disease? Results from the prospective multicenter international CONFIRM registry. Eur Heart J Cardiovasc Imaging 15:267–274
doi: 10.1093/ehjci/jet148
pubmed: 23966421
Hoffmann U, Moselewski F, Nieman K et al (2006) Noninvasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by multidetector computed tomography. J Am Coll Cardiol 47:1655–1662
doi: 10.1016/j.jacc.2006.01.041
pubmed: 16631006
Motoyama S, Ito H, Sarai M et al (2015) Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. J Am Coll Cardiol 66:337–346
doi: 10.1016/j.jacc.2015.05.069
pubmed: 26205589
Deseive S, Kupke M, Straub R et al (2020) Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification. Eur Heart J Cardiovasc Imaging 22:314–321. https://doi.org/10.1093/ehjci/jeaa228
doi: 10.1093/ehjci/jeaa228
van Rosendael AR, Shaw LJ, Xie JX et al (2019) Superior risk stratification with coronary computed tomography angiography using a comprehensive atherosclerotic risk score. JACC Cardiovasc Imaging 12:1987–1997
doi: 10.1016/j.jcmg.2018.10.024
pubmed: 30660516
pmcid: 6635103
Ndrepepa G, Iijima R, Kufner S et al (2016) Association of progression or regression of coronary artery atherosclerosis with long-term prognosis. Am Heart J 177:9–16
doi: 10.1016/j.ahj.2016.03.016
pubmed: 27297844
Lee SE, Sung JM, Rizvi A et al (2018) Quantification of coronary atherosclerosis in the assessment of coronary artery disease. Circ Cardiovasc Imaging 11:e007562
doi: 10.1161/CIRCIMAGING.117.007562
pubmed: 30012825
Papadopoulou SL, Neefjes LA, Garcia-Garcia HM et al (2012) Natural history of coronary atherosclerosis by multislice computed tomography. JACC Cardiovasc Imaging 5:S28-37
doi: 10.1016/j.jcmg.2012.01.009
pubmed: 22421228
Pontone G, Rossi A, Guglielmo M et al (2022) Clinical applications of cardiac computed tomography: a consensus paper of the European Association of Cardiovascular Imaging-part II. Eur Heart J Cardiovasc Imaging 23:e136–e161
doi: 10.1093/ehjci/jeab292
pubmed: 35175348
pmcid: 8944330
Pontone G, Rossi A, Guglielmo M et al (2022) Clinical applications of cardiac computed tomography: a consensus paper of the European Association of Cardiovascular Imaging-part I. Eur Heart J Cardiovasc Imaging 23:299–314
doi: 10.1093/ehjci/jeab293
pubmed: 35076061
pmcid: 8863074
Gulati M, Levy PD, Mukherjee D et al (2021) 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 144:e368–e454
pubmed: 34709928
Lee SE, Chang HJ, Rizvi A et al (2016) Rationale and design of the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry: a comprehensive exploration of plaque progression and its impact on clinical outcomes from a multicenter serial coronary computed tomographic angiography study. Am Heart J 182:72–79
doi: 10.1016/j.ahj.2016.09.003
pubmed: 27914502
Abbara S, Blanke P, Maroules CD et al (2016) SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 10:435–449
doi: 10.1016/j.jcct.2016.10.002
pubmed: 27780758
Leipsic J, Abbara S, Achenbach S et al (2014) SCCT guidelines for the interpretation and reporting of coronary CT angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 8:342–358
doi: 10.1016/j.jcct.2014.07.003
pubmed: 25301040
Choi AD, Thomas DM, Lee J et al (2021) 2020 SCCT Guideline for Training Cardiology and Radiology Trainees as Independent Practitioners (Level II) and Advanced Practitioners (Level III) in Cardiovascular Computed Tomography: a statement from the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 15:2–15
doi: 10.1016/j.jcct.2020.08.003
pubmed: 33032977
Pontone G, Moharem-Elgamal S, Maurovich-Horvat P et al (2018) Training in cardiac computed tomography: EACVI certification process. Eur Heart J Cardiovasc Imaging 19:123–126
doi: 10.1093/ehjci/jex310
pubmed: 29236986
Hadamitzky M, Achenbach S, Al-Mallah M et al (2013) Optimized prognostic score for coronary computed tomographic angiography: results from the CONFIRM registry (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter Registry). J Am Coll Cardiol 62:468–476
doi: 10.1016/j.jacc.2013.04.064
pubmed: 23727215
Puchner SB, Liu T, Mayrhofer T et al (2014) High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial. J Am Coll Cardiol 64:684–692
doi: 10.1016/j.jacc.2014.05.039
pubmed: 25125300
pmcid: 4135448
Maurovich-Horvat P, Hoffmann U, Vorpahl M, Nakano M, Virmani R, Alkadhi H (2010) The napkin-ring sign: CT signature of high-risk coronary plaques? JACC Cardiovasc Imaging 3:440–444
doi: 10.1016/j.jcmg.2010.02.003
pubmed: 20394906
Han D, Lin A, Kuronuma K et al (2022) Association of plaque location and vessel geometry determined by coronary computed tomographic angiography with future acute coronary syndrome-causing culprit lesions. JAMA Cardiol 7:309–319
doi: 10.1001/jamacardio.2021.5705
pubmed: 35080587
pmcid: 8792800
Min JK, Shaw LJ, Devereux RB et al (2007) Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 50:1161–1170
doi: 10.1016/j.jacc.2007.03.067
pubmed: 17868808
Ferencik M, Mayrhofer T, Bittner DO et al (2018) Use of high-risk coronary atherosclerotic plaque detection for risk stratification of patients with stable chest pain: a secondary analysis of the PROMISE Randomized Clinical Trial. JAMA Cardiol 3:144–152
doi: 10.1001/jamacardio.2017.4973
pubmed: 29322167
pmcid: 5838601
Lee SE, Sung JM, Andreini D et al (2020) Differences in progression to obstructive lesions per high-risk plaque features and plaque volumes with CCTA. JACC Cardiovasc Imaging 13:1409–1417
doi: 10.1016/j.jcmg.2019.09.011
pubmed: 31734214
Kumamaru KK, Kondo T, Kumamaru H, Amanuma M, George E, Rybicki FJ (2014) Repeat coronary computed tomographic angiography in patients with a prior scan excluding significant stenosis. Circ Cardiovasc Imaging 7:788–795
doi: 10.1161/CIRCIMAGING.113.001549
pubmed: 25037056
Moise A, Theroux P, Taeymans Y et al (1984) Clinical and angiographic factors associated with progression of coronary artery disease. J Am Coll Cardiol 3:659–667
doi: 10.1016/S0735-1097(84)80240-5
pubmed: 6693637
Bittencourt MS, Hulten E, Ghoshhajra B et al (2014) Prognostic value of nonobstructive and obstructive coronary artery disease detected by coronary computed tomography angiography to identify cardiovascular events. Circ Cardiovasc Imaging 7:282–291
Hadamitzky M, Taubert S, Deseive S et al (2013) Prognostic value of coronary computed tomography angiography during 5 years of follow-up in patients with suspected coronary artery disease. Eur Heart J 34:3277–3285
doi: 10.1093/eurheartj/eht293
pubmed: 24067508
van Rosendael SE, van den Hoogen IJ, Lin FY et al (2022) Clinical and coronary plaque predictors of atherosclerotic nonresponse to statin therapy. JACC Cardiovasc Imaging. https://doi.org/10.1016/j.jcmg.2022.10.017
Thomsen C, Abdulla J (2016) Characteristics of high-risk coronary plaques identified by computed tomographic angiography and associated prognosis: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging 17:120–129
Dweck MR, Maurovich-Horvat P, Leiner T et al (2020) Contemporary rationale for non-invasive imaging of adverse coronary plaque features to identify the vulnerable patient: a Position Paper from the European Society of Cardiology Working Group on Atherosclerosis and Vascular Biology and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 21:1177–1183
doi: 10.1093/ehjci/jeaa201
pubmed: 32887997
Cury RC, Leipsic J, Abbara S et al (2022) CAD-RADS 2.0 - 2022 Coronary Artery Disease-Reporting and Data System: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI). JACC Cardiovasc Imaging 15:1974–2001
doi: 10.1016/j.jcmg.2022.07.002
pubmed: 36115815
Einstein AJ, Moser KW, Thompson RC, Cerqueira MD, Henzlova MJ (2007) Radiation dose to patients from cardiac diagnostic imaging. Circulation 116:1290–1305
doi: 10.1161/CIRCULATIONAHA.107.688101
pubmed: 17846343
Stocker TJ, Deseive S, Leipsic J et al (2018) Reduction in radiation exposure in cardiovascular computed tomography imaging: results from the PROspective multicenter registry on radiaTion dose Estimates of cardiac CT angIOgraphy iN daily practice in 2017 (PROTECTION VI). Eur Heart J 39:3715–3723
doi: 10.1093/eurheartj/ehy546
pubmed: 30165629
pmcid: 6455904
Mortensen MB, Steffensen FH, Botker HE et al (2020) CAD Severity on Cardiac CTA Identifies Patients With Most Benefit of Treating LDL Cholesterol to ACC/AHA and ESC/EAS Targets. JACC Cardiovasc Imaging 13(9):1961–1972. https://doi.org/10.1016/j.jcmg.2020.03.017
doi: 10.1016/j.jcmg.2020.03.017
pubmed: 32563656
Shaw LJ, Blankstein R, Bax JJ et al (2021) Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque. J Cardiovasc Comput Tomogr 15:93–109
doi: 10.1016/j.jcct.2020.11.002
pubmed: 33303383