Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization
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Author
Fujimoto, Shinichiro
Kondo, Takeshi
Shinozaki, Tomohiro
Takamura, Kazuhisa
Kawaguchi, Yuko
Matsumori, Rie
Hiki, Makoto
Miyauchi, Katsumi
Daida, Hiroyuki
Rybicki, Frank J
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1161/JAHA.115.002264Metadata
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Fujimoto, S., T. Kondo, K. K. Kumamaru, T. Shinozaki, K. Takamura, Y. Kawaguchi, R. Matsumori, et al. 2015. “Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 4 (8): e002264. doi:10.1161/JAHA.115.002264. http://dx.doi.org/10.1161/JAHA.115.002264.Abstract
Background: Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. Methods and Results: Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell’s C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). Conclusions: High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599477/pdf/Terms of Use
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