Coronary plaque characteristics in computed tomography and 2-year outcomes: The PREDICT study
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Coronary computed tomography angiography (CCTA) not only provides information regarding luminal stenoses but also allows for visualization of mural atheromatous changes (coronary plaques). OBJECTIVE: We sought to elucidate whether plaques seen on CCTA enable prediction of 2-year outcomes in patients with suspected and known coronary artery disease (CAD). METHODS: Of 3015 patients who underwent CCTA, the images and 2-year clinical courses of 2802 patients were independently analyzed. The primary endpoint was the composite of all-cause death and acute coronary syndrome. RESULTS: During the 2-year observation period, 49 (1.7%) patients developed the primary outcome. The 2-year rates of the primary outcome in the normal (n = 515, no mural lesions), calcium (n = 654, calcified lesion alone), and plaque groups (n = 1633, presence of noncalcified or partially calcified plaques) were 0.2%, 2.0%, and 2.1%, respectively (P = 0.0028). Adverse plaque features such as low attenuation, positive remodeling, spotty calcification, and the napkin-ring sign (low-attenuation core with a higher-attenuation rim) were assessed by an independent core laboratory. Stepwise multivariate Cox proportional hazard analysis showed that a plaque with two or more characteristics (adjusted hazard ratio, 1.98; 95% confidence interval, 1.09-3.60; P = 0.0254), age of ≥67 years (mean), statin treatment after CCTA, and obstructive stenosis remained independent predictors of the primary outcome. CONCLUSIONS: Plaque imaging in CCTA has predictive value for the 2-year outcome and is a useful identifier for high-risk patients among those with known and suspected CAD.
Authors: Hideya Yamamoto, Yasuki Kihara, Toshiro Kitagawa, Norihiko Ohashi, Eiji Kunita, Yoshitaka Iwanaga, Kazuhiro Kobuke, Shunichi Miyazaki, Tomohiro Kawasaki, Shinichiro Fujimoto, Hiroyuki Daida, Takashi Fujii, Aki Sato, Tomokazu Okimoto, Sachio Kuribayashi, Hiroto Utsunomiya, Atsuhiro Senoo, Eriko Matsunaga, Kazuhisa Takamura, Ryoko Kinoshita, Yasuhiko Hayashi, Hideo Himeno, Takeshi Kondo, Shinichiro Fujimoto, Akira Yamashina, Masaharu Hirano, Kenji Ando, Kyohei Yamaji, Noriko Inoue, Keigo Dote, Masaya Kato, Shota Sasaki, Masaki Kawamura, Kiyotaka Oshima, Atsushi Hirayama, Shunichi Yoda, Hideaki Yoshino, Haruhisa Ishiguro, Osamu Doi, Shota Fukuda, Kenei Shimada, Tomoko Nao, Kengo Tanabe, Teruhito Mochizuki, Akira Kurata, Hiroshi Morishita, Naoya Matsumoto, Hiroshi Ohta
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,410
Funders: American Heart Association, Pfizer, Philips, AstraZeneca, Bayer, Novartis, Roche, Sanofi, Medtronic, Meso Scale Diagnostics, Takeda Science Foundation, Takeda Pharmaceutical Company, Kowa Company, Boehringer Ingelheim Japan, ResMed, Nippon Shinyaku, Ministry of Education, Culture, Sports, Science and Technology, Daiichi-Sankyo, Dainippon Sumitomo Pharma, Ministry of Health, Labour and Welfare, Kyowa Hakko Kirin, Astellas Pharma, Shionogi, Toshiba Medical Systems, Terumo, Teijin Pharma, Foundation for Biomedical Research and Innovation, Japan Heart Foundation
OpenAlex ID: W2835404129