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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 A.R.Lin F.Y.van den Hoogen I.J.Ma X.Gianni U.Al Hussein Alawamlh O.Al'Aref S.J.Peña J.M.Andreini D.Budoff M.J.Cademartiri F.Chinnaiyan K.Choi J.H.Conte E.Marques H.de Araújo Gonçalves P.Gottlieb I.Hadamitzky M.Leipsic J.Maffei E.Pontone G.Raff G.L.Shin S.Kim Y.-J.Lee B.K.Chun E.J.Sung J.M.Lee S.-E.Han D.Berman D.S.Virmani R.Samady H.Stone P.Narula J.Bax J.J.Shaw L.J.Min J.K.Chang H.-J.
Ewha Authors
신상훈
SCOPUS Author ID
신상훈scopus
Issue Date
2021
Journal Title
Journal of Cardiovascular Computed Tomography
ISSN
1934-5925JCR Link
Citation
Journal of Cardiovascular Computed Tomography
Keywords
Coronary artery diseaseCoronary CTAPlaque progressionRisk stratification
Publisher
Elsevier Inc.
Indexed
SCIE; SCOPUS 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. © 2020 Society of Cardiovascular Computed Tomography
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DOI
10.1016/j.jcct.2020.12.007
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의료원 > 의료원 > Journal papers
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