TY - JOUR
T1 - Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events
AU - van Rosendael, Alexander R.
AU - Lin, Fay Y.
AU - van den Hoogen, Inge J.
AU - Ma, Xiaoyue
AU - Gianni, Umberto
AU - Al Hussein Alawamlh, Omar
AU - Al'Aref, Subhi J.
AU - Peña, Jessica M.
AU - Andreini, Daniele
AU - Budoff, Matthew J.
AU - Cademartiri, Filippo
AU - Chinnaiyan, Kavitha
AU - Choi, Jung Hyun
AU - Conte, Edoardo
AU - Marques, Hugo
AU - de Araújo Gonçalves, Pedro
AU - Gottlieb, Ilan
AU - Hadamitzky, Martin
AU - Leipsic, Jonathon
AU - Maffei, Erica
AU - Pontone, Gianluca
AU - Raff, Gilbert L.
AU - Shin, Sanghoon
AU - Kim, Yong Jin
AU - Lee, Byoung Kwon
AU - Chun, Eun Ju
AU - Sung, Ji Min
AU - Lee, Sang Eun
AU - Han, Donghee
AU - Berman, Daniel S.
AU - Virmani, Renu
AU - Samady, Habib
AU - Stone, Peter
AU - Narula, Jagat
AU - Bax, Jeroen J.
AU - Shaw, Leslee J.
AU - Min, James K.
AU - Chang, Hyuk Jae
N1 - Publisher Copyright:
© 2020 Society of Cardiovascular Computed Tomography
PY - 2021/7/1
Y1 - 2021/7/1
N2 - 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.
AB - 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.
KW - Coronary CTA
KW - Coronary artery disease
KW - Plaque progression
KW - Risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85099478733&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2020.12.007
DO - 10.1016/j.jcct.2020.12.007
M3 - Article
C2 - 33451974
AN - SCOPUS:85099478733
SN - 1934-5925
VL - 15
SP - 322
EP - 330
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 4
ER -