Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization.
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.


METHODS AND 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.
['Fujimoto|Shinichiro|S|', 'Kondo|Takeshi|T|', 'Kumamaru|Kanako K|KK|', 'Shinozaki|Tomohiro|T|', 'Takamura|Kazuhisa|K|', 'Kawaguchi|Yuko|Y|', 'Matsumori|Rie|R|', 'Hiki|Makoto|M|', 'Miyauchi|Katsumi|K|', 'Daida|Hiroyuki|H|', 'Rybicki|Frank J|FJ|']
D000328:Adult D000368:Aged D017023:Coronary Angiography D003324:Coronary Artery Disease D003331:Coronary Vessels D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D061330:Multidetector Computed Tomography D015999:Multivariate Analysis D009204:Myocardial Revascularization 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
prognostic value coronary artery calcium score computed tomography–high risk plaque coronary computed tomography angiography coronary revascularization