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  • Title: Prognostic value of coronary atherosclerosis progression evaluated by coronary CT angiography in patients with stable angina.
    Author: Gu H, Gao Y, Hou Z, Schoepf UJ, Snyder AN, Duguay TM, Wang X, Lu B.
    Journal: Eur Radiol; 2018 Mar; 28(3):1066-1076. PubMed ID: 28963687.
    Abstract:
    OBJECTIVES: To investigate the progression of coronary atherosclerosis burden by coronary CT angiography (CCTA) and to demonstrate its association with the incidence of major adverse cardiac events (MACE). METHODS: We retrospectively studied patients with stable angina who had undergone repeat CCTA due to recurrent or worsening symptoms. Lipid-rich, fibrous, calcified and total plaque burden as well as coronary diameter stenosis were quantitatively analysed. The incidence of MACE during follow-up was determined. RESULTS: The final cohort consisted of 268 patients (mean age 52.9 ± 9.8 years, 71 % male) with a mean follow-up period of 4.6 ± 0.9 years. Patients with lipid-rich, fibrous, calcified and total plaque burden (%) progression, as well as coronary diameter stenosis (%) progression had a significantly higher incidence of MACE than those without (all p < 0.05). The progression of lipid-rich plaque (HR = 1.601, p = 0.021), total plaque burden (HR = 2.979, p = 0.043) and coronary diameter stenosis (HR = 4.327, p <0.001) were independent predictors of MACE (all p < 0.05). CONCLUSIONS: Patients presenting with recurrent or worsening symptoms associated with coronary artery disease who have coronary atherosclerosis progression on CCTA are at an increased risk of future MACE. KEY POINTS: • Repeat CCTA can provide information regarding the progression of coronary atherosclerosis. • Coronary atherosclerosis progression at CCTA is independently associated with MACE. • CCTA findings could serve as incremental predictors of MACE.
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