Coronary CT angiography in prediction of major adverse cardiac events in patients with coronary plaques / 中国医学影像技术

ABSTRACT

Objective To explore the value of coronary CT angiography (CCTA) in prediction of major adverse cardiac events (MACE) in patients with coronary plaques.Methods Totally 256 coronary atherosclerotic plaque patients underwent CCTA.The degree of coronary stenosis was assessed quantitatively,and the plaque components were analyzed and classified.The occurrence of MACE was followed up.Three models were established for predicting MACE,including model 1 (classification of CCTA stenosis),model 2 (classification of CCTA stenosis combined with plaque typing) and model 3 (CCTA combined with plaque typing and clinical risk factors).The ability of the three models to predict MACE was evaluated.Results Follow-up was completed in 209 patients.Forty-six patients had experienced MACE.Classification of CCTA stenosis and plaque typing were used to assess the risk of MACE,and the hazard ratio (HR) was 4.47 and 3.43,respectively,both higher than those of clinical risk factors.The predictive ability of MACE by model 2 and model 3 was significantly superior to that of model 1 (P＜0.05),and there was no significant difference between model 2 and model 3 (P=0.076).Conclusion CCTA can assess the risk of MACE from both coronary stenosis and plaque typing.The new modality of CCTA stenosis classification combined with plaque typing could promote the ability of CCTA to predict the risk of MACE.