Abstract 15854: Prognostic Value of Coronary CT Angiography and Coronary Artery Calcium Score Performed Before Revascularization

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A15854-A15854
• Main Authors: Takamura, Kazuhisa, Fujimoto, Shinichiro, Kondo, Takeshi, Kumamaru, Kanako, Kawaguchi, Yuko, Suda, Shoko, matsumori, Rie, Kato, Etsuro, Hiki, Makoto, Takase, Shinichi, Rybicki, Frank J, Daida, Hiroyuki
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.15854

IntroductionCardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of non-culprit lesions. Because coronary CT angiography (CCTA) performed before revascularization can evaluate all plaque, including non-culprit lesions, and in theory can serve as a predictor of cardiac events after treatment. We evaluated the hypothesis that CCTA and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment.MethodsAmong 2238 consecutive patients without known coronary artery disease who underwent coronary CCTA 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 revascularizationCACS and the presence of CT-verified high risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from discrimination (Harrell’s C-statistics) and reclassification (net reclassification indices (NRI)) standpoints.ResultsDuring the follow-up period (median673, interquartile range47-1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS and non-culprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). Reclassification improved by including CACS into the model when compared to the model without it (NRI=12.7%; category-free NRI=40.7%) and CT-HRP added to CACS further improved the classification (NRI=6.9%; category-free NRI=14.3%).ConclusionsHigh CACS and the presence of non-culprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization.