Abstract 16606: 30-day and 2-year Prognostic Information of Total Atheroma Volume, Segment Stenosis Score, and Traditional Coronary Artery Stenosis Assessment by CT Angiography - Results From the CORE320 International Study
Introduction: Among abundant information on coronary artery disease (CAD) features by CT angiography (CTA), total atheroma volume and segment stenosis score (SSS) have recently shown promise for clinical utility.
Methods: We followed 379 patients with suspected or known CAD enrolled in the CORE320 study for 2 years after 320-detector row CT coronary angiography. CT images were analyzed for semi-automatically derived total % atheroma volume (total atherosclerotic burden/vessel volume analyzed) and SSS in addition to traditional stenosis assessment (≥50%). Outcome variables were 1) 30-day revascularization and 2) major adverse cardiac events (MACE) after 2 years follow up. Events included cardiac death, myocardial infarction, hospitalization for acute chest pain or heart failure, arrhythmia, and revascularization. Area under the curve (AUC) and Kaplan-Meyer analysis were used to compare risk prediction and survival analysis according to CT CAD characteristics.
Results: Thirty-day revascularization was most accurately predicted by CT stenosis assessment (AUC 75, confidence interval [CI] 71-80) vs. % atheroma volume (70 [65-74] and CTA SSS (67 [62-72]) (p=0.007). Prediction of MACE (45 late revascularizations, 5 myocardial infarctions, 1 cardiac death, 8 hospitalizations for chest pain or congestive heart failure, and 1 arrhythmia) was similar for % atheroma volume (64 [71 for patients without history of CAD]) and CTA stenosis assessment (65 ) but risk discrimination using common criteria trended favorably for % atheroma volume (FIGURE). Accuracy was low for CTA SSS (58 ).
Conclusions: Semi-automated assessment of % total atheroma volume by CTA performs similarly to standard stenosis assessment for predicting short and long term event rates, especially revascularization, in patients with suspected CAD and holds promise for more nuanced risk discrimination. In contrast, CTA segment stenosis score performed only modestly in our analysis.
Author Disclosures: A. Arbab-Zadeh: None. T. Magalhaes: None. S. Kishi: None. C. Rochitte: None. M.Y. Chen: None. K.F. Kofoed: None. M. Dewey: Research Grant; Significant; Toshiba Medical Systems, GE Medical, Bracco, Guerbet. Speakers Bureau; Modest; Toshiba Medical, Guerbet, Bayer Schering. Consultant/Advisory Board; Modest; Guerbet. R.T. George: Research Grant; Significant; Toshiba Medical Systems, GE Medical, Astellas Pharma, Capricor. Consultant/Advisory Board; Significant; ICON Medical Imaging. H. Niinuma: None. K. Kitagawa: None. M. Matheson: None. A. Vavere: None. J.M. Miller: None. F. Rybicki: None. C. Cox: None. M. Di Carli: None. M.E. Clouse: None. J. Brinker: None. J. Lima: Research Grant; Significant; Toshiba Medical Systems.
- © 2015 by American Heart Association, Inc.