Coronary Artery Calcium Score Predicts Major Adverse Cardiovascular Events in Stable Chest Pain

被引：0

作者：

Biavati, Federico ^{[1
]}

Saba, Luca ^{[5
]}

Boussoussou, Melinda ^{[6
]}

Kofoed, Klaus F. ^{[8
,9
]}

Benedek, Theodora ^{[11
,13
]}

Donnelly, Patrick ^{[14
]}

Rodriguez-Palomares, Jose ^{[15
,17
]}

Erglis, Andrejs ^{[18
,20
]}

Stechovsky, Cyril ^{[21
]}

Sakalyte, Gintare ^{[23
]}

Adic, Nada Cemerlic ^{[25
,26
]}

Gutberlet, Matthias ^{[27
]}

Dodd, Jonathan D. ^{[29
,31
]}

Diez, Ignacio ^{[32
]}

Davis, Gershan ^{[34
,36
]}

Zimmermann, Elke ^{[1
]}

Kepka, Cezary ^{[37
]}

Vidakovic, Radosav ^{[38
,39
]}

Francone, Marco ^{[40
,42
]}

Ilnicka-Suckiel, Malgorzata ^{[43
]}

Plank, Fabian ^{[45
,46
]}

Knuuti, Juhani ^{[48
]}

Faria, Rita ^{[50
]}

Schroder, Stephen ^{[51
]}

Berry, Colin ^{[52
,53
]}

Ruzsics, Balazs ^{[54
,55
]}

Rieckmann, Nina ^{[2
]}

Kubiak, Christine ^{[56
]}

Hansen, Kristian Schultz ^{[57
]}

Mueller-Nordhorn, Jacqueline ^{[58
]}

Maurovich-Horvat, Pal ^{[6
,7
]}

Sigvardsen, Per E. ^{[8
,9
]}

Benedek, Imre ^{[59
]}

Orr, Clare ^{[14
]}

Valente, Filipa Xavier ^{[15
,17
]}

Zvaigzne, Ligita ^{[19
]}

Suchanek, Vojtech ^{[22
]}

Jankauskas, Antanas ^{[24
]}

Adic, Filip ^{[25
,26
]}

Woinke, Michael ^{[28
]}

Cadogan, Diarmaid ^{[30
]}

Lecumberri, Inigo ^{[33
]}

Thwaite, Erica ^{[35
]}

Kruk, Mariusz ^{[37
]}

Neskovic, Aleksandar N. ^{[38
,39
]}

Mancone, Massimo ^{[41
]}

Kusmierz, Donata ^{[44
]}

Feuchtner, Gudrun ^{[47
]}

Pietila, Mikko ^{[49
]}

Ribeiro, Vasco Gama ^{[50
]}

机构：

[1] Charite Univ Med Berlin, Dept Radiol, Campus Mitte, Charitepl 1, D-10117 Berlin, Germany

[2] Charite Univ Med Berlin, Inst Publ Hlth, Charitepl 1, D-10117 Berlin, Germany

[3] Charite Univ Med Berlin, Inst Biometry & Clin Epidemiol, Charitepl 1, D-10117 Berlin, Germany

[4] Charite Univ Med Berlin, Dept Cardiol & Angiol, Charitepl 1, D-10117 Berlin, Germany

[5] Univ Cagliari, Dept Radiol, Cagliari, Italy

[6] Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary

[7] Semmelweis Univ, Med Imaging Ctr, Dept Radiol, Budapest, Hungary

[8] Univ Copenhagen, Dept Cardiol, Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

[9] Univ Copenhagen, Dept Radiol, Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

[10] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark

[11] George Emil Palade Univ Med Pharm Sci & Technol, Dept Internal Med, Clin Cardiol, Targu Mures, Romania

[12] George Emil Palade Univ Med Pharm Sci & Technol, Dept Cardiol, Targu Mures, Romania

[13] Cty Clin Emergency Hosp Targu Mures, Targu Mures, Romania

[14] Southeastern Hlth & Social Care Trust, Dept Cardiol, Belfast, North Ireland

[15] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Inst Recerca, Dept Cardiol, Barcelona, Spain

[16] Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Inst Recerca, Dept Radiol, Barcelona, Spain

[17] Ctr Invest Biomed Red, Madrid, Spain

[18] Paul Stradins Clin Univ Hosp, Dept Cardiol, Riga, Latvia

[19] Paul Stradins Clin Univ Hosp, Dept Radiol, Riga, Latvia

[20] Univ Latvia, Riga, Latvia

[21] Motol Univ Hosp, Dept Cardiol, Prague, Czech Republic

[22] Motol Univ Hosp, Dept Imaging Methods, Prague, Czech Republic

[23] Hosp Lithuanian Univ Hlth Sci, Med Acad, Dept Cardiol, Kaunas, Lithuania

[24] Hosp Lithuanian Univ Hlth Sci, Dept Radiol, Kaunas, Lithuania

[25] Univ Novi Sad, Fac Med, Novi Sad, Serbia

[26] Inst Cardiovasc Dis Vojvodina, Dept Cardiol, Novi Sad, Serbia

[27] Univ Leipzig, Dept Radiol, Heart Ctr, Leipzig, Germany

[28] Univ Leipzig, Dept Cardiol, Heart Ctr, Leipzig, Germany

[29] St Vincents Univ Hosp, Dept Radiol, Dublin, Ireland

[30] St Vincents Univ Hosp, Dept Cardiol, Dublin, Ireland

[31] Univ Coll Dublin, Sch Med, Dublin, Ireland

[32] Basurto Hosp, Dept Cardiol, Bilbao, Spain

[33] Basurto Hosp, Dept Radiol, Bilbao, Spain

[34] Aintree Univ Hosp NHS Fdn Trust, Dept Cardiol, Liverpool, England

[35] Aintree Univ Hosp NHS Fdn Trust, Dept Radiol, Liverpool, England

[36] Edge Hill Univ, Ormskirk, England

[37] Natl Inst Cardiol, Warsaw, Poland

[38] Univ Belgrade, Dept Cardiol Internal Med Clin, Clin Hosp Ctr Zemun, Belgrade, Serbia

[39] Univ Belgrade, Fac Med, Belgrade, Serbia

[40] Sapienza Univ Rome, Dept Radiol Oncol & Pathol Sci, Rome, Italy

[41] Sapienza Univ Rome, Dept Clin Internal Anesthesiol & Cardiovasc Sci, Rome, Italy

[42] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[43] Prov Specialist Hosp Wroclaw, Dept Cardiol, Wroclaw, Poland

[44] Prov Specialist Hosp Wroclaw, Dept Radiol, Wroclaw, Poland

[45] Innsbruck Med Univ, Dept Internal Med 3, Innsbruck, Austria

[46] Innsbruck Med Univ, Dept Cardiol, Innsbruck, Austria

[47] Innsbruck Med Univ, Dept Radiol, Innsbruck, Austria

[48] Turku Univ Hosp, Turku PET Ctr, Turku, Finland

[49] Turku Univ Hosp, Heart Ctr, Turku, Finland

[50] Ctr Hosp Vila Nova de Gaia Espinho, Dept Cardiol, Vila Nova De Gaia, Portugal

来源：

RADIOLOGY | 2024年 / 310卷 / 03期

关键词：

COMPUTED-TOMOGRAPHY; PROGNOSTIC VALUE; ATHEROSCLEROSIS; QUANTIFICATION; ANGIOGRAPHY; DISEASE;

D O I：

暂无

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background: Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose: To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods: This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA. Participants were randomly assigned to undergo either ICA or coronary CT. CAC scores from noncontrast CT scans were categorized into low, intermediate, and high groups based on scores of 0, 1-399, and 400 or higher, respectively. The end point of the study was the occurrence of MACE (myocardial infarction, stroke, and cardiovascular death) over a median 3.5 -year follow-up, analyzed using Cox proportional hazard regression tests. Results: The study involved 1749 participants (mean age, 60 years +/- 10 [SD]; 992 female). The prevalence of obstructive coronary artery disease (CAD) at CT angiography rose from 4.1% (95% CI: 2.8, 5.8) in the CAC score 0 group to 76.1% (95% CI: 70.3, 81.2) in the CAC score 400 or higher group. Revascularization rates increased from 1.7% to 46.2% across the same groups (P < .001). The CAC score 0 group had a lower MACE risk (0.5%; HR, 0.08 [95% CI: 0.02, 0.30]; P < .001), as did the 1-399 CAC score group (1.9%; HR, 0.27 [95% CI: 0.13, 0.59]; P = .001), compared with the 400 or higher CAC score group (6.8%). No significant difference in MACE between sexes was observed (P = .68). Conclusion: In participants with stable chest pain initially referred for ICA, a CAC score of 0 showed very low risk of MACE, and CAC scores showed risk of obstructive CAD, revascularization, and MACE at

引用

页数：11

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