Standardized reporting systems for computed tomography coronary angiography and calcium scoring: A real-world validation of CAD-RADS and CAC-DRS in patients with stable chest pain

被引：44

作者：

Williams, Michelle C. ^{[1
,2
]}

Moss, Alastair ^{[1
]}

Dweck, Marc ^{[1
]}

Hunter, Amanda ^{[1
]}

Pawade, Tania ^{[1
]}

Adamson, Philip D. ^{[1
,3
]}

Shah, Anoop S., V ^{[1
]}

Alam, Shirjel ^{[1
]}

Maroules, Christopher D. ^{[4
]}

van Beek, Edwin J. R. ^{[2
]}

Cury, Ricardo ^{[5
]}

Nicol, Edward D. ^{[6
,7
,8
]}

Newby, David E. ^{[1
,2
]}

Roditi, Giles ^{[9
,10
]}

机构：

[1] Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[2] Univ Edinburgh, Edinburgh Imaging Facil QMRI, Edinburgh, Midlothian, Scotland

[3] Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand

[4] Naval Med Ctr, Dept Radiol, Portsmouth, VA USA

[5] Baptist Hlth South Florida, Miami Cardiac & Vasc Inst, Miami, FL USA

[6] Royal Brompton & Harefield NHS Fdn Trust, Dept Cardiol, London, England

[7] Royal Brompton & Harefield NHS Fdn Trust, Dept Radiol, London, England

[8] Imperial Coll, Fac Med, Natl Heart & Lung Inst, London, England

[9] Queen Elizabeth Univ Hosp, Glasgow Clin Res Imaging Facil, Glasgow, Lanark, Scotland

[10] Glasgow Univ, Glasgow, Lanark, Scotland

来源：

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY | 2020年 / 14卷 / 01期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

Computed tomography; Computed tomography coronary angiography; Chest pain; Angina; Standardized reporting; ARTERY CALCIUM; MYOCARDIAL-INFARCTION; PROGNOSTIC VALUE; RISK STRATIFICATION; FAMILY-HISTORY; CT ANGIOGRAPHY; DISEASE RISK; FOLLOW-UP; HEART; EVENTS;

D O I：

10.1016/j.jcct.2019.07.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: To assess the prognostic implications of standardized reporting systems for coronary computed tomography angiography (CCTA) and coronary artery calcium scores (CACS) in patients with stable chest pain. Background: The Coronary Artery Disease Reporting And Data System (CAD-RADS) and Coronary Artery Calcium - Data and Reporting System (CAC-DRS) aim to improve communication of CACS and CCTA results, but its influence on prognostication is unknown. Methods: Images from 1769 patients who underwent CCTA as part of the Scottish Computed Tomography of the HEART (SCOT-HEART) multi-center randomized controlled trial were assessed. CACS were classified as CAC-DRS 0 to 3 based on Agatston scores. CCTA were classified as CAD-RADS 0 to 5 based on the most clinically relevant finding per patient. The primary outcome was the five-year events of fatal and non-fatal myocardial infarction. Results: Patients had a mean age of 58 +/- 10 years and 56% were male. CAC-DRS 0, 1, 2 and 3 occurred in 642 (36%), 510 (29%), 239 (14%) and 379 (21%) patients respectively. CAD-RADS 0, 1, 2, 3, 4A, 4B and 5 occurred in 622 (35%), 327 (18%), 211 (12%), 165 (9%), 221 (12%), 42 (2%) and 181 (10%) patients respectively. Patients classified as CAC-DRS 3 were at an increased risk of fatal or non-fatal myocardial infarction compared to CAC-DRS 0 patients (hazard ratio (HR) 9.41; 95% confidence interval (CI) 3.24, 27.31; p < 0.001). Patients with higher CAD-RADS categories were at an increased risk of fatal or non-fatal myocardial infarction, with patients classified as CAD-RADS 4B at the highest risk compared to CAD-RADS 0 patients (HR 19.14; 95% CI 4.28, 85.53; p < 0.001). Conclusion: Patients with higher CAC-DRS and CAD-PADS scores were at increased risk of subsequent fatal and non-fatal myocardial infarction. This confirms that the classification provides additional prognostic discrimination for future coronary heart disease events.

引用

页码：3 / 11

页数：9

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