title: Prognostic Value of Gai's Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis.
abstract: BACKGROUND
  The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions, using fractional flow reserve (FFR) as the gold standard.
  
  
  METHODS
  We retrospectively analyzed 107 visually assessed significant coronary lesions in 88 patients (mean age, 59.6 ± 10.2 years; 76.14% of males) who underwent CCTA, invasive coronary angiography, and invasive FFR measurement. An FFR <0.80 indicated hemodynamically significant coronary stenosis. Lesions were divided into two groups using an FFR cutoff value of 0.80. We compared Gai's plaque scores and CACS between the two groups and evaluated the correlations of these scores with FFR. The statistical methods included unpaired t-test, Mann-Whitney U-test, and Spearman's correlation coefficients.
  
  
  RESULTS
  Coronary lesions with FFR <0.80 had higher Gai's scores than those with FFR ≥0.80. Gai's score had the strongest correlation with FFR (r = -0.48, P < 0.01) and had a greater area under the curve = 0.72 (95% confidence interval: 0.61-0.82; P < 0.01) than the CACS of whole arteries and a single artery.
  
  
  CONCLUSIONS
  Both CACS in a single artery and Gai's plaque score demonstrated a good capacity to assess functionally significant coronary artery stenosis when compared to the gold standard FFR. However, Gai's plaque score was more predictive of FFR <0.80. Gai's score can be easily calculated in daily clinical practice and could be used when considering revascularization.
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Chuang
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Rheumatism, Medical College of Qing Hai University, Xining, Qinghai 810016, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Lu-Yue
authors.initials: LY
authors.lastname: Gai
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Zhi-Qi
authors.initials: ZQ
authors.lastname: Han
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Xin
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Qin-Hua
authors.initials: QH
authors.lastname: Jin
mesh_terms: D000368:Aged; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D061205:Vascular Calcification / Q000473:pathology*