TY - JOUR
T1 - Adding coronary computed tomography angiography to invasive coronary angiography improves prediction of cardiac events
AU - Kawai, Hideki
AU - Tanizawa, Sadako
AU - Sarai, Masayoshi
AU - Ito, Hajime
AU - Takahashi, Hiroshi
AU - Harigaya, Hiroto
AU - Kan, Shino
AU - Ishii, Junichi
AU - Anno, Hirofumi
AU - Murohara, Toyoaki
AU - Ozaki, Yukio
N1 - Copyright:
This record is sourced from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PY - 2014
Y1 - 2014
N2 - BACKGROUND: The additive value of plaque characteristics determined by computed tomography angiography (CTA) in patients undergoing invasive coronary angiography (ICA) has not been established. METHODS AND RESULTS: We studied 676 patients undergoing ICA and CTA within 3 months. The luminal diameter narrowing based on ICA and the presence of high risk plaque (HRP) based on CTA were assessed in all coronary artery segments except for those after or before scheduled treatment. We followed their cardiac events including cardiac death, acute coronary syndrome (ACS), and revascularization for de novo lesions ≥3 months after ICA. The incidence of coronary events was higher in the segments including >25% luminal narrowing than in those without (2.94% vs. 0.31%, P<0.0001), and higher in the segments containing HRP than in those without (12.6 vs. 0.46%, P<0.0001). Greater than 25% residual luminal narrowing and the presence of HRP were identified as independent predictors of cardiac events after risk adjustment for age, gender, and history of ACS (hazard ratio [HR], 3.22; 95% confidence interval [CI]: 1.29-10.76; P=0.0092, HR, 2.64; 95% CI: 1.59-4.35; P=0.0002, respectively). Adding the presence of HRP to a model including age, gender, ACS history, and >25% residual stenosis improved the prediction of cardiac events.CONCLUSIONS: Assessment of coronary plaque characteristics on CTA improves the prediction of cardiac events in patients undergoing ICA.
AB - BACKGROUND: The additive value of plaque characteristics determined by computed tomography angiography (CTA) in patients undergoing invasive coronary angiography (ICA) has not been established. METHODS AND RESULTS: We studied 676 patients undergoing ICA and CTA within 3 months. The luminal diameter narrowing based on ICA and the presence of high risk plaque (HRP) based on CTA were assessed in all coronary artery segments except for those after or before scheduled treatment. We followed their cardiac events including cardiac death, acute coronary syndrome (ACS), and revascularization for de novo lesions ≥3 months after ICA. The incidence of coronary events was higher in the segments including >25% luminal narrowing than in those without (2.94% vs. 0.31%, P<0.0001), and higher in the segments containing HRP than in those without (12.6 vs. 0.46%, P<0.0001). Greater than 25% residual luminal narrowing and the presence of HRP were identified as independent predictors of cardiac events after risk adjustment for age, gender, and history of ACS (hazard ratio [HR], 3.22; 95% confidence interval [CI]: 1.29-10.76; P=0.0092, HR, 2.64; 95% CI: 1.59-4.35; P=0.0002, respectively). Adding the presence of HRP to a model including age, gender, ACS history, and >25% residual stenosis improved the prediction of cardiac events.CONCLUSIONS: Assessment of coronary plaque characteristics on CTA improves the prediction of cardiac events in patients undergoing ICA.
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U2 - 10.1253/circj.CJ-14-0743
DO - 10.1253/circj.CJ-14-0743
M3 - Article
C2 - 25298167
AN - SCOPUS:84928491127
SN - 1346-9843
VL - 78
SP - 2735
EP - 2740
JO - Circulation journal : official journal of the Japanese Circulation Society
JF - Circulation journal : official journal of the Japanese Circulation Society
IS - 11
ER -