title: Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization.
abstract: BACKGROUND
  Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment.
  
  
  RESULTS
  Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell's C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%).
  
  
  CONCLUSIONS
  High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization.
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.) Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).
authors: Shinichiro
authors: S
authors: Fujimoto
authors: Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).
authors: Takeshi
authors: T
authors: Kondo
authors: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA (K.K.K., F.J.R.).
authors: Kanako K
authors: KK
authors: Kumamaru
authors: Department of Biostatistics, School of Public Health, The University of Tokyo, Japan (T.S.).
authors: Tomohiro
authors: T
authors: Shinozaki
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.) Department of Cardiology, Takase Clinic, Takasaki, Japan (S.F., T.K., K.T.).
authors: Kazuhisa
authors: K
authors: Takamura
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).
authors: Yuko
authors: Y
authors: Kawaguchi
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).
authors: Rie
authors: R
authors: Matsumori
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).
authors: Makoto
authors: M
authors: Hiki
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).
authors: Katsumi
authors: K
authors: Miyauchi
authors: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (S.F., K.T., Y.K., R.M., M.H., K.M., H.D.).
authors: Hiroyuki
authors: H
authors: Daida
authors: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA (K.K.K., F.J.R.).
authors: Frank J
authors: FJ
authors: Rybicki
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D009204:Myocardial Revascularization / Q000009:adverse effects; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000628:therapy*
keywords: computed tomography–high risk plaque; coronary artery calcium score; coronary computed tomography angiography; coronary revascularization; prognostic value