Your browser doesn't support javascript.
loading
Atherosclerosis quantification and cardiovascular risk: the ISCHEMIA trial.
Nurmohamed, Nick S; Min, James K; Anthopolos, Rebecca; Reynolds, Harmony R; Earls, James P; Crabtree, Tami; Mancini, G B John; Leipsic, Jonathon; Budoff, Matthew J; Hague, Cameron J; O'Brien, Sean M; Stone, Gregg W; Berger, Jeffrey S; Donnino, Robert; Sidhu, Mandeep S; Newman, Jonathan D; Boden, William E; Chaitman, Bernard R; Stone, Peter H; Bangalore, Sripal; Spertus, John A; Mark, Daniel B; Shaw, Leslee J; Hochman, Judith S; Maron, David J.
Afiliación
  • Nurmohamed NS; Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
  • Min JK; Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
  • Anthopolos R; Division of Cardiology, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC 20037, USA.
  • Reynolds HR; Cleerly, Inc, Denver, CO, USA.
  • Earls JP; New York University Grossman School of Medicine, New York, NY, USA.
  • Crabtree T; New York University Grossman School of Medicine, New York, NY, USA.
  • Mancini GBJ; Cleerly, Inc, Denver, CO, USA.
  • Leipsic J; Department of Radiology, The George Washington University School of Medicine, Washington, DC, USA.
  • Budoff MJ; Cleerly, Inc, Denver, CO, USA.
  • Hague CJ; Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
  • O'Brien SM; Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
  • Stone GW; Lundquist Institute, Torrance, CA, USA.
  • Berger JS; Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
  • Donnino R; Duke Clinical Research Institute, Durham, NC, USA.
  • Sidhu MS; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Newman JD; New York University Grossman School of Medicine, New York, NY, USA.
  • Boden WE; New York University Grossman School of Medicine, New York, NY, USA.
  • Chaitman BR; Albany Medical College, Albany, NY, USA.
  • Stone PH; New York University Grossman School of Medicine, New York, NY, USA.
  • Bangalore S; VA New England Healthcare System, Boston University School of Medicine, Boston, MA, USA.
  • Spertus JA; St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St Louis, MO, USA.
  • Mark DB; Brigham and Women's Hospital, Boston, MA, USA.
  • Shaw LJ; New York University Grossman School of Medicine, New York, NY, USA.
  • Hochman JS; University of Missouri-Kansas City's Healthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.
  • Maron DJ; Duke Clinical Research Institute, Durham, NC, USA.
Eur Heart J ; 45(36): 3735-3747, 2024 Sep 29.
Article en En | MEDLINE | ID: mdl-39101625
ABSTRACT
BACKGROUND AND

AIMS:

The aim of this study was to determine the prognostic value of coronary computed tomography angiography (CCTA)-derived atherosclerotic plaque analysis in ISCHEMIA.

METHODS:

Atherosclerosis imaging quantitative computed tomography (AI-QCT) was performed on all available baseline CCTAs to quantify plaque volume, composition, and distribution. Multivariable Cox regression was used to examine the association between baseline risk factors (age, sex, smoking, diabetes, hypertension, ejection fraction, prior coronary disease, estimated glomerular filtration rate, and statin use), number of diseased vessels, atherosclerotic plaque characteristics determined by AI-QCT, and a composite primary outcome of cardiovascular death or myocardial infarction over a median follow-up of 3.3 (interquartile range 2.2-4.4) years. The predictive value of plaque quantification over risk factors was compared in an area under the curve (AUC) analysis.

RESULTS:

Analysable CCTA data were available from 3711 participants (mean age 64 years, 21% female, 79% multivessel coronary artery disease). Amongst the AI-QCT variables, total plaque volume was most strongly associated with the primary outcome (adjusted hazard ratio 1.56, 95% confidence interval 1.25-1.97 per interquartile range increase [559 mm3]; P = .001). The addition of AI-QCT plaque quantification and characterization to baseline risk factors improved the model's predictive value for the primary outcome at 6 months (AUC 0.688 vs. 0.637; P = .006), at 2 years (AUC 0.660 vs. 0.617; P = .003), and at 4 years of follow-up (AUC 0.654 vs. 0.608; P = .002). The findings were similar for the other reported outcomes.

CONCLUSIONS:

In ISCHEMIA, total plaque volume was associated with cardiovascular death or myocardial infarction. In this highly diseased, high-risk population, enhanced assessment of atherosclerotic burden using AI-QCT-derived measures of plaque volume and composition modestly improved event prediction.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Placa Aterosclerótica / Angiografía por Tomografía Computarizada Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Placa Aterosclerótica / Angiografía por Tomografía Computarizada Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido