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Per-lesion versus per-patient analysis of coronary artery disease in predicting the development of obstructive lesions: the Progression of AtheRosclerotic PlAque DetermIned by Computed TmoGraphic Angiography Imaging (PARADIGM) study
- Title
- Per-lesion versus per-patient analysis of coronary artery disease in predicting the development of obstructive lesions: the Progression of AtheRosclerotic PlAque DetermIned by Computed TmoGraphic Angiography Imaging (PARADIGM) study
- Authors
- Lee S.-E.; Sung J.M.; Andreini D.; Al-Mallah M.H.; Budoff M.J.; Cademartiri F.; Chinnaiyan K.; Choi J.H.; Chun E.J.; Conte E.; Gottlieb I.; Hadamitzky M.; Kim Y.J.; Lee B.K.; Leipsic J.A.; Maffei E.; Marques H.; de Araújo Gonçalves P.; Pontone G.; Shin S.; Stone P.H.; Samady H.; Virmani R.; Narula J.; Berman D.S.; Shaw L.J.; Bax J.J.; Lin F.Y.; Min J.K.; Chang H.-J.
- Ewha Authors
- 이상은
- SCOPUS Author ID
- 이상은
- Issue Date
- 2020
- Journal Title
- International Journal of Cardiovascular Imaging
- ISSN
- 1569-5794
- Citation
- International Journal of Cardiovascular Imaging vol. 36, no. 12, pp. 2357 - 2364
- Keywords
- Coronary artery atherosclerosis; Coronary artery disease; Coronary computed tomography angiography; Statins
- Publisher
- Springer Science and Business Media B.V.
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- To determine whether the assessment of individual plaques is superior in predicting the progression to obstructive coronary artery disease (CAD) on serial coronary computed tomography angiography (CCTA) than per-patient assessment. From a multinational registry of 2252 patients who underwent serial CCTA at a ≥ 2-year inter-scan interval, patients with only non-obstructive lesions at baseline were enrolled. CCTA was quantitatively analyzed at both the per-patient and per-lesion level. Models predicting the development of an obstructive lesion at follow up using either the per-patient or per-lesion level CCTA measures were constructed and compared. From 1297 patients (mean age 60 ± 9 years, 43% men) enrolled, a total of 3218 non-obstructive lesions were identified at baseline. At follow-up (inter-scan interval: 3.8 ± 1.6 years), 76 lesions (2.4%, 60 patients) became obstructive, defined as > 50% diameter stenosis. The C-statistics of Model 1, adjusted only by clinical risk factors, was 0.684. The addition of per-patient level total plaque volume (PV) and the presence of high-risk plaque (HRP) features to Model 1 improved the C-statistics to 0.825 [95% confidence interval (CI) 0.823–0.827]. When per-lesion level PV and the presence of HRP were added to Model 1, the predictive value of the model improved the C-statistics to 0.895 [95% CI 0.893–0.897]. The model utilizing per-lesion level CCTA measures was superior to the model utilizing per-patient level CCTA measures in predicting the development of an obstructive lesion (p < 0.001). Lesion-level analysis of coronary atherosclerotic plaques with CCTA yielded better predictive power for the development of obstructive CAD than the simple quantification of total coronary atherosclerotic burden at a per-patient level. Clinical Trial Registration: ClinicalTrials.gov NCT0280341 © 2020, Springer Nature B.V.
- DOI
- 10.1007/s10554-020-01960-z
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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