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dc.contributor.author김은희-
dc.date.accessioned2020-08-13T16:30:08Z-
dc.date.available2020-08-13T16:30:08Z-
dc.date.issued2020-
dc.identifier.issn1229-6929-
dc.identifier.issn2005-8330-
dc.identifier.otherOAK-27280-
dc.identifier.urihttps://dspace.ewha.ac.kr/handle/2015.oak/254910-
dc.description.abstractObjective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis >= 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.-
dc.languageEnglish-
dc.publisherKOREAN RADIOLOGICAL SOC-
dc.subjectCoronary computed tomography angiography-
dc.subjectCoronary artery calcium scoring-
dc.subjectStroke-
dc.subjectPlaque-
dc.subjectatherosclerotic-
dc.subjectCoronary stenosis-
dc.titlePrognostic Value of Coronary CT Angiography for Predicting Poor Cardiac Outcome in Stroke Patients without Known Cardiac Disease or Chest Pain: The Assessment of Coronary Artery Disease in Stroke Patients Study-
dc.typeArticle-
dc.relation.issue9-
dc.relation.volume21-
dc.relation.indexSCIE-
dc.relation.indexSCOPUS-
dc.relation.indexKCI-
dc.relation.startpage1055-
dc.relation.lastpage1064-
dc.relation.journaltitleKOREAN JOURNAL OF RADIOLOGY-
dc.identifier.doi10.3348/kjr.2020.0103-
dc.identifier.wosidWOS:000550662500004-
dc.identifier.scopusid2-s2.0-85088165495-
dc.author.googleYoon, Sung Hyun-
dc.author.googleKim, Eunhee-
dc.author.googleJeon, Yongho-
dc.author.googleYi, Sang Yoon-
dc.author.googleBae, Hee-Joon-
dc.author.googleJang, Ik-Kyung-
dc.author.googleLee, Joo Myung-
dc.author.googleYoo, Seung Min-
dc.author.googleWhite, Charles S.-
dc.author.googleChun, Eun Ju-
dc.date.modifydate20200820114624-
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