1. Prognostic utility of semi-quantitative coronary computed tomography angiography scores in the SCOT-HEART trial.
- Author
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Maclean E, Cronshaw R, Newby DE, Nicol E, and Williams MC
- Subjects
- Humans, Male, Middle Aged, Aged, Female, Prognosis, Computed Tomography Angiography adverse effects, Coronary Angiography methods, Constriction, Pathologic complications, Risk Factors, Predictive Value of Tests, Tomography, X-Ray Computed adverse effects, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease complications, Myocardial Infarction diagnostic imaging, Myocardial Infarction etiology
- Abstract
Background: Information from cardiac computed tomography angiography can be summarized using visual semi-quantitative scores. However, the optimal method and their prognostic utility is unknown., Methods: Five semi-quantitative scores were calculated in the SCOT-HEART trial, including segment involvement score (SIS), segment stenosis score (SSS), CT Leaman (CT-LeSc), multivessel aggregate stenosis score (MVAS), and CAD-RADS 2.0 including plaque modifier (P). Prediction of fatal or non-fatal myocardial infarction and major adverse cardiovascular events (MACE) was compared to the 10-year cardiovascular risk score., Results: Imaging was performed in 1,769 individuals (age 58 ± 10 years, 56% male) with 41 (2.3%) experiencing myocardial infarction and 74 (4%) MACE over 4.9 ± 1.1 years. P based on calcium score and SIS had good agreement (weighted Cohen's kappa 0.79, 95% confidence interval [CI] 0.79, 0.79). SIS, SSS, CT-LeSec, and MVAS performed similarly for the prediction of myocardial infarction (area under the curve [AUC] 0.74, 0.75, 0.75, 0.74, all p > 0.1) and MACE (AUC 0.73, 0.74, 0.74, 0.73, all p > 0.1), and were superior to the cardiovascular risk score (AUC 0.62 and 0.65, both p < 0.001). High semi-quantitative scores were associated with increased risk of myocardial infarction and MACE, with the greatest adjusted risk associated with CT-LeSc≥8 (Hazard ratio [HR] 5.6, 95% confidence interval [CI] 2.7, 11.6, p < 0.001 and HR 5.2, 95% CI 3.1, 8.7, p < 0.001) and SSS≥10 (HR 4.7, 95% CI 2.4, 8.9, p < 0.001 and HR 5.3, 95% CI 3.3, 8.5, p < 0.001)., Conclusions: Semi-quantitative scores performed similarly for the prediction of myocardial infarction and MACE, with all superior to the cardiovascular risk score., (Copyright © 2023 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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