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Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events
- Title
- Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events
- Authors
- van Rosendael, Alexander R.; Lin, Fay Y.; van den Hoogen, Inge J.; Ma, Xiaoyue; Gianni, Umberto; Alawamlh, Omar Al Hussein; Al'Aref, Subhi J.; Pena, Jessica M.; Andreini, Daniele; Budoff, Matthew J.; Cademartiri, Filippo; Chinnaiyan, Kavitha; Choi, Jung Hyun; Conte, Edoardo; Marques, Hugo; Goncalves, Pedro de Araujo; Gottlieb, Ilan; Hadamitzky, Martin; Leipsic, Jonathon; Maffei, Erica; Pontone, Gianluca; Raff, Gilbert L.; Shin, Sanghoon; Kim, Yong-Jin; Lee, Byoung Kwon; Chun, Eun Ju; Sung, Ji Min; Lee, Sang-Eun; Han, Donghee; Berman, Daniel S.; Virmani, Renu; Samady, Habib; Stone, Peter; Narula, Jagat; Bax, Jeroen J.; Shaw, Leslee J.; Min, James K.; Chang, Hyuk-Jae
- Ewha Authors
- 신상훈
- SCOPUS Author ID
- 신상훈
- Issue Date
- 2021
- Journal Title
- JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
- ISSN
- 1934-5925
- Citation
- JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY vol. 15, no. 4, pp. 322 - 330
- Keywords
- Coronary artery disease; Plaque progression; Coronary CTA; Risk stratification
- Publisher
- ELSEVIER SCIENCE INC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: The current study aimed to examine the independent prognostic value of whole-heart atherosclerosis progression by serial coronary computed tomography angiography (CCTA) for major adverse cardiovascular events (MACE). Methods: The multi-center PARADIGM study includes patients undergoing serial CCTA for symptomatic reasons, >2 years apart. Whole-heart atherosclerosis was characterized on a segmental level, with co-registration of baseline and follow-up CCTA, and summed to per-patient level. The independent prognostic significance of atherosclerosis progression for MACE (non-fatal myocardial infarction [MI], death, unplanned coronary revascularization) was examined. Patients experiencing interval MACE were not omitted. Results: The study population comprised 1166 patients (age 60.5 +/- 9.5 years, 54.7% male) who experienced 139 MACE events during 8.2 (IQR 6.2, 9.5) years of follow up (15 death, 5 non-fatal MI, 119 unplanned revascularizations). Whole-heart percent atheroma volume (PAV) increased from 2.32% at baseline to 4.04% at follow-up. Adjusted for baseline PAV, the annualized increase in PAV was independently associated with MACE: OR 1.23 (95% CI 1.08, 1.39) per 1 standard deviation increase, which was consistent in multiple subpopulations. When categorized by composition, only non-calcified plaque progression associated independently with MACE, while calcified plaque did not. Restricting to patients without events before follow-up CCTA, those with future MACE showed an annualized increase in PAV of 0.93% (IQR 0.34, 1.96) vs 0.32% (IQR 0.02, 0.90), P < 0.001. Conclusions: Whole-heart atherosclerosis progression examined by serial CCTA is independently associated with MACE, with a prognostic threshold of 1.0% increase in PAV per year.
- DOI
- 10.1016/j.jcct.2020.12.007
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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