Baumann Stefan, Kaeder Finja, Schoepf U Joseph, Golden Joseph W, Kryeziu Philipp, Tesche Christian, Renker Matthias, Jannsen Sonja, Weiss Christel, Hetjens Svetlana, Schoenberg Stefan O, Borggrefe Martin, Akin Ibrahim, Lossnitzer Dirk, Overhoff Daniel
First Department of Medicine-Cardiology, University Medical Centre Mannheim.
DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Mannheim.
J Thorac Imaging. 2021 Mar 1;36(2):108-115. doi: 10.1097/RTI.0000000000000509.
In this study, we analyzed the prognostic value of coronary computed tomography angiography-derived morphologic and quantitative plaque markers and plaque scores for major adverse cardiovascular events (MACEs).
We analyzed the data of patients with suspected coronary artery disease (CAD). Various plaque markers were obtained using a semiautomated software prototype or derived from the results of the software analysis. Several risk scores were calculated, and follow-up data concerning MACE were collected from all patients.
A total of 131 patients (65±12 y, 73% male) were included in our study. MACE occurred in 11 patients within the follow-up period of 34±25 months.CAD-Reporting and Data System score (odds ratio [OR]=11.62), SYNTAX score (SS) (OR=1.11), Leiden-risk score (OR=1.37), segment involvement score (OR=1.76), total plaque volume (OR=1.20), and percentage aggregated plaque volume (OR=1.32) were significant predictors for MACE (all P≤0.05). Moreover, the difference of the corrected coronary opacification (ΔCCO) correlated significantly with the occurrence of MACE (P<0.0001). The CAD-Reporting and Data System score, SS, and Leiden-risk score showed substantial sensitivity for predicting MACE (90.9%). The SS and Leiden-risk score displayed high specificities of 80.8% and 77.5%, respectively. These plaque markers and risk scores all provided high negative predictive value (>90%).
The coronary computed tomography angiography-derived plaque markers of segment involvement score, total plaque volume, percentage aggregated plaque volume, and ΔCCO, and the risk scores exhibited predictive value for the occurrence of MACE and can likely aid in identifying patients at risk for future cardiac events.
在本研究中，我们分析了冠状动脉计算机断层扫描血管造影得出的形态学和定量斑块标志物及斑块评分对主要不良心血管事件（MACE）的预后价值。
我们分析了疑似冠状动脉疾病（CAD）患者的数据。使用半自动软件原型获取各种斑块标志物，或从软件分析结果中得出。计算了多个风险评分，并收集了所有患者关于MACE的随访数据。
我们的研究共纳入了131例患者（65±12岁，73%为男性）。在34±25个月的随访期内，11例患者发生了MACE。CAD报告和数据系统评分（优势比[OR]=11.62）、SYNTAX评分（SS）（OR=1.11）、莱顿风险评分（OR=1.37）、节段累及评分（OR=1.76）、总斑块体积（OR=1.20）和聚集斑块体积百分比（OR=1.32）是MACE的显著预测因素（所有P≤0.05）。此外，校正后的冠状动脉造影剂充盈（ΔCCO）差异与MACE的发生显著相关（P<0.0001）。CAD报告和数据系统评分、SS和莱顿风险评分对预测MACE具有较高的敏感性（90.9%）。SS和莱顿风险评分的特异性分别为80.8%和77.5%。这些斑块标志物和风险评分均具有较高的阴性预测值（>90%）。
冠状动脉计算机断层扫描血管造影得出的节段累及评分、总斑块体积、聚集斑块体积百分比和ΔCCO等斑块标志物以及风险评分对MACE的发生具有预测价值，可能有助于识别未来发生心脏事件的风险患者。
