Prognostic Value of Coronary CT Angiography and Calcium Score for Major Adverse Cardiac Events in Outpatients

Hou, Zhiyong; Lü, Bin; Gao, Yang; Jiang, Shiliang; Wang, Yang; Li, Wei; Budoff, Matthew J.

doi:10.1016/j.jcmg.2012.06.006

Cited by 278 publications

(234 citation statements)

References 28 publications

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“…According to the CONFIRM registry, the absence of CAD is associated with an excellent outcome, whereas the risk for death increases by the extent of CAD. These data were confirmed by a study from Hou et al [21]. In 5007 persons they were able to demonstrate that CTA was superior to CS in terms of predicting cardiovascular events.…”

Section: Prognostic Value Of Ctasupporting

confidence: 52%

Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT

Tsiflikas

Thomas

Fallmann

et al. 2015

Fortschr Röntgenstr

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Ziel: Ziel der Studie war die Evaluierung der Präva-lenz der KHK bei männlichen Marathonläufern mittleren Alters mittels Dual Source cCTA (DSCTA). Material und Methoden: 50 Marathonläufer (52,7 ± 5,9 Jahre) wurden zusätzlich zur sportmedizinischen Routinediagnostik mittels DSCTA einschließlich Calcium-Scoring (CS) untersucht. Das CS wurde bei allen Personen im high-pitchModus (hpDSCTA), die CTA bei 21 Personen im hpDSCTA und 29 Personen im sequentiellen "step-and-shot"-Modus (sDSCTA) durchgeführt. Die effektive Dosis (ED) wurde für beide Scanverfahren bestimmt. Der Risikofaktor für koronare Ereignisse wurde basierend auf Standardrisikofaktoren mittels des PROCAM-Scores berechnet. Der Koronarstatus wurde wie folgt klassifiziert: 1. keine KHK (CS = 0, keine Koronarplaques), 2. milde Koronarsklerose (CS> 0, Stenose < 50 %), 3. moderate Koronarsklerose (CS > 0, Stenose > 50 %) 4. signifikante KHK (CS > 0, Stenose > 75 %). Ergebnisse: Der mediane PROCAM-Score betrug 1,85 ± 1,56 %. 26 von 50 Marathonläufern hatten keine KHK. 1 Person hatte eine signifikante KHK, 3 Personen eine moderate sowie 20 eine milde Koronarsklerose. Die Laufband-Ergometrie konnte bei keinem Sportler Koronarischämien nachweisen. Als Faktoren für ein erhöhtes KHK-Risiko konnten Alter, Blutdruck, persönliche Mindestzeit, familiäre Anamnese und der PROCAM-Score identifiziert werden. Die mediane ED für die DSCTA lag bei 1,259 ± 0,542 mSv. Bei der hpDSCTA war die ED im Vergleich zur sDSCTA signifikant niedriger (0,762 vs. 1,618 mSv, p < 0,0001). Schlussfolgerung: Bei fast 50 % der asymptomatischen Marathonläufer über 45 Jahren kann mittels cCTA eine Koronarsklerose nachgewiesen werden. Bei 24 % dieser Probanden waren die Plaques in den proximalen Abschnitten der Koronararterien lokalisiert. Tatsächlich leidet jedoch nur ein kleiner Anteil dieser Personen an einer obstruktiven KHK. Abstract !Purpose: To evaluate the prevalence of coronary artery disease (CAD) in middle-aged, male marathon runners using coronary dual source CT angiography (DSCTA). Materials and Methods: 50 male marathon runners older than 45 years (mean age: 52.7, standard deviation: 5.9 years, range: 45 to 67 years) received DSCTA including calcium scoring (CS) in addition to standard pre-participation screening. Based on standard risk factors, the risk for coronary events was calculated using the PROCAM score. Coronary status was defined using the following system: 1. absence of CAD (CS zero, no coronary plaques) 2. mild coronary atherosclerosis (CS > 0, coronary plaques with luminal narrowing < 50 %), 3. moderate coronary atherosclerosis (CS > 0, luminal narrowing > 50 %), 4. significant CAD (CS > 0, luminal narrowing > 75 %). Results: The mean PROCAM score was 1.85 % (standard deviation = 1.56, range 0.39 to 8.47 %). 26/50 marathon runners had no atherosclerosis. 1 of the remaining 24 participants had significant CAD, 3 had moderate coronary atherosclerosis and 20 had mild coronary atherosclerosis. Treadmill exercise testing was unremarkable in terms of myocardial ischemia in all p...

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Section: Prognostic Value Of Ctasupporting

confidence: 52%

Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT

Tsiflikas

Thomas

Fallmann

et al. 2015

Fortschr Röntgenstr

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“…Studies based on single center and multicenter clinical trials have shown that coronary CT angiography provides incremental prognostic value over clinical risk analysis in predicting major adverse cardiac events with absence of CAD leading to event free survival period, while presence of plaques associated with increased risk of cardiac events [15][16][17][18][19].…”

Section: Disease; Diagnostic Value; Imaging Modalitiesmentioning

confidence: 99%

“…Cardiac PET utilizing 18 F-FDG is considered the most sensitive modality for detecting hibernating viable myocardium and predicting left ventricular functional recovery post-coronary revascularization. PET has higher spatial and temporal resolution than SPECT due to more robust methods of attenuation correction, thus, PET allows quantification of resting and hyperemic regional myocardial perfusion.…”

Section: Journal Ofmentioning

confidence: 99%

“…PET has higher spatial and temporal resolution than SPECT due to more robust methods of attenuation correction, thus, PET allows quantification of resting and hyperemic regional myocardial perfusion. When PET was integrated into clinical patient management, a significant reduction in cardiac events was observed in patients with 18 F-FDG PET-assisted management, according to randomized controlled trials [39,40]. PET images provide incremental prognostic information to the clinical and angiographic findings with regard to event-free survival.…”

Section: Journal Ofmentioning

confidence: 99%

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Cardiac Imaging Modalities in the Diagnosis of Coronary Artery Disease

Sun¹

2013

J Clin Exp Cardiolog

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Coronary artery disease is the leading cause of death in advanced countries. Early detection and diagnosis of coronary artery disease plays an important role in the identification of disease severity and prediction of disease outcome, consequently improving patient management. Diagnosis and management of coronary artery disease is increasingly dependent on less-invasive imaging modalities, including coronary CT angiography, cardiac magnetic resonance imaging, cardiac radionuclide imaging such as SPECT and PET modalities. Rapid developments of these imaging modalities have significantly improved the diagnostic performance of each imaging technique with high diagnostic accuracy achieved in both diagnostic and prognostic value in coronary artery disease. This editorial provides an overview of the diagnostic applications of a variety of less-invasive imaging modalities in the diagnosis of coronary artery disease. This special issue of "Arteriosclerotic Vascular Disease: Part II" in the journal of Clinical and Experimental Cardiology will give particular attention to contributions focusing on the clinical applications of these imaging modalities in the arteriosclerotic vascular disease, in particular, coronary artery disease.

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“…Therefore, imaging early calcification is important to identify individuals with enhanced risk of cardiovascular events. Furthermore, many studies have demonstrated coronary artery calcification as a marker for the extent of atherosclerosis and overall plaque burden, and as an important independent predictor of cardiovascular events, mortality, and morbidity 5, 6, 7, 8. Over the past few decades, advanced imaging methods have improved our assessment of atherosclerotic calcification and have provided insights into cardiovascular risk and have contributed to the understanding of the underlying pathophysiologic mechanisms of atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Imaging Cardiovascular Calcification

Wang

Osborne

Tung

et al. 2018

JAHA

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Prognostic Value of Coronary CT Angiography and Calcium Score for Major Adverse Cardiac Events in Outpatients

Abstract: The CACS and coronary CTA findings have prognostic value and have incremental value over routine risk factors for MACE, and coronary CTA is superior to CACS. Cardiac CT seems to be a promising noninvasive modality with significant prognostic value.

Cited by 278 publications

References 28 publications

Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT

Prevalence of Subclinical Coronary Artery Disease in Middle-Aged, Male Marathon Runners Detected by Cardiac CT

Cardiac Imaging Modalities in the Diagnosis of Coronary Artery Disease

Imaging Cardiovascular Calcification

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