Saima Mushtaq1, Pedro De Araujo Gonçalves1, Hector M Garcia-Garcia1, Gianluca Pontone1, Antonio L Bartorelli1, Erika Bertella1, Carlos M Campos1, Mauro Pepi1, Patrick W Serruys1, Daniele Andreini2. 1. From the Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., G.P., A.L.B., E.B., M.P., D.A.); Cardiology Department, Hospital de Santa Cruz, CHLO, Lisbon, Portugal (P.D.A.G.); Cardiovascular Center, Hospital da Luz, ESS, Lisbon, Portugal (P.D.A.G.); CEDOC, Chronic Diseases Research Center, FCM-NOVA, Lisbon, Portugal (P.D.A.G.); Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands (H.M.G.-G., C.M.C., P.W.S.); Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (A.L.B., D.A.); and Department of Cardiology, Imperial College London, London, United Kingdom (P.W.S.). 2. From the Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., G.P., A.L.B., E.B., M.P., D.A.); Cardiology Department, Hospital de Santa Cruz, CHLO, Lisbon, Portugal (P.D.A.G.); Cardiovascular Center, Hospital da Luz, ESS, Lisbon, Portugal (P.D.A.G.); CEDOC, Chronic Diseases Research Center, FCM-NOVA, Lisbon, Portugal (P.D.A.G.); Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands (H.M.G.-G., C.M.C., P.W.S.); Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (A.L.B., D.A.); and Department of Cardiology, Imperial College London, London, United Kingdom (P.W.S.). daniele.andreini@ccfm.it.
Abstract
BACKGROUND: Computed tomography-adapted Leaman score (CT-LeSc) was developed to quantify coronary CT angiography information about atherosclerotic burden (lesion localization, stenosis degree, and plaque composition). The objective of the study is to evaluate CT-LeSc long-term prognostic value in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: Single-center prospective registry including 1304 consecutive patients undergoing coronary CT angiography for suspected CAD. High CT-LeSc was defined by upper tertile (score, >5) cutoff. Segment involvement score and segment stenosis score were also evaluated. Hard cardiac events (cardiac death and nonfatal acute coronary syndromes) were considered for analysis. Different Cox regression models were used to identify independent event predictors. Kaplan-Meier event-free survival was evaluated in 4 patient subgroups stratified by obstructive (≥50% stenosis) versus nonobstructive CAD and a high (>5) versus a low (≤5) CT-LeSc. Of 1196 patients included in the final analysis (mean follow-up of 52±22 months), 125 patients experienced 136 hard events (18 cardiac deaths and 118 nonfatal myocardial infarction). All atherosclerotic burden scores were independent predictors of cardiac events (hazard ratios of 3.09 for segment involvement score, 4.42 for segment stenosis score, and 5.39 for CT-LeSc). Cumulative event-free survival was 76.8% with a high CT-LeSc and 96.0% with a low CT-LeSc. Event-free survival in nonobstructive CAD with high CT-LeSc (78.6%) was similar to obstructive CAD with high CT-LeSc (76.5%) but lower than obstructive CAD with low CT-LeSc (80.7%). CONCLUSIONS: CT-LeSc is an independent long-term predictor of hard cardiac events. Patients with nonobstructive CAD and high CT-LeSc had hard event-free survival similar to patients with obstructive CAD.
BACKGROUND: Computed tomography-adapted Leaman score (CT-LeSc) was developed to quantify coronary CT angiography information about atherosclerotic burden (lesion localization, stenosis degree, and plaque composition). The objective of the study is to evaluate CT-LeSc long-term prognostic value in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: Single-center prospective registry including 1304 consecutive patients undergoing coronary CT angiography for suspected CAD. High CT-LeSc was defined by upper tertile (score, >5) cutoff. Segment involvement score and segment stenosis score were also evaluated. Hard cardiac events (cardiac death and nonfatal acute coronary syndromes) were considered for analysis. Different Cox regression models were used to identify independent event predictors. Kaplan-Meier event-free survival was evaluated in 4 patient subgroups stratified by obstructive (≥50% stenosis) versus nonobstructive CAD and a high (>5) versus a low (≤5) CT-LeSc. Of 1196 patients included in the final analysis (mean follow-up of 52±22 months), 125 patients experienced 136 hard events (18 cardiac deaths and 118 nonfatal myocardial infarction). All atherosclerotic burden scores were independent predictors of cardiac events (hazard ratios of 3.09 for segment involvement score, 4.42 for segment stenosis score, and 5.39 for CT-LeSc). Cumulative event-free survival was 76.8% with a high CT-LeSc and 96.0% with a low CT-LeSc. Event-free survival in nonobstructive CAD with high CT-LeSc (78.6%) was similar to obstructive CAD with high CT-LeSc (76.5%) but lower than obstructive CAD with low CT-LeSc (80.7%). CONCLUSIONS: CT-LeSc is an independent long-term predictor of hard cardiac events. Patients with nonobstructive CAD and high CT-LeSc had hard event-free survival similar to patients with obstructive CAD.
Authors: Petar Medakovic; Zrinka Biloglav; Ivan Padjen; Ivan Pristas; Mladen Jukic; Franko Zuvela; Gordana Ivanac; Boris Brkljacic; Tena Jukic; Lana Turk Journal: Int J Cardiovasc Imaging Date: 2018-05-25 Impact factor: 2.357
Authors: Alexander R van Rosendael; A Maxim Bax; Jeff M Smit; Inge J van den Hoogen; Xiaoyue Ma; Subhi Al'Aref; Stephan Achenbach; Mouaz H Al-Mallah; Daniele Andreini; Daniel S Berman; Matthew J Budoff; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Kavitha Chinnaiyan; Benjamin J W Chow; Ricardo C Cury; Augustin DeLago; Gudrun Feuchtner; Martin Hadamitzky; Joerg Hausleiter; Philipp A Kaufmann; Yong-Jin Kim; Jonathon A Leipsic; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Gianluca Pontone; Gilbert L Raff; Ronen Rubinshtein; Todd C Villines; Heidi Gransar; Yao Lu; Jessica M Peña; Fay Y Lin; Leslee J Shaw; James K Min; Jeroen J Bax Journal: Eur Heart J Cardiovasc Imaging Date: 2020-05-01 Impact factor: 6.875