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Prognostic Implications of Comprehensive Whole Vessel Plaque Quantification Using Coronary Computed Tomography Angiography

Seokhun Yang, Joo Myung Lee, Masahiro Hoshino, Tadashi Murai, Ki Hong Choi, Doyeon Hwang, Kyung-Jin Kim, Eun‐Seok Shin, Joon‐Hyung Doh, Hyuk‐Jae Chang, Chang‐Wook Nam, Jinlong Zhang, Jianan Wang, Shao‐Liang Chen, Nobuhiro Tanaka, Hitoshi Matsuo, Takashi Akasaka, Tsunekazu Kakuta, Bon‐Kwon Koo

2021JACC Asia18 citationsDOIOpen Access PDF

Abstract

Background: The prognostic value of whole vessel plaque quantification has not been fully understood. Objectives: We aimed to investigate the clinical relevance of whole vessel plaque quantification on coronary computed tomography angiography. Methods: , or percent total atheroma volume ≥32.2% in a target vessel, based on corresponding optimal cutoff values. Survival analysis for vessel-oriented composite outcome (VOCO) (a composite of cardiac death, target vessel myocardial infarction, or target vessel revascularization) at 5 years was performed using marginal Cox proportional hazard models. Results: 0.001). In a landmark analysis at 2 years, the number of HRVC showed sustained prognostic implications beyond 2 years, but the number of HRPC did not. Conclusions: Whole vessel plaque quantification can provide incremental predictability for low FFR and additive prognostic value in deferred vessels with high FFR over anatomical severity and lesion plaque characteristics. (CCTA-FFR Registry for Risk Prediction; NCT04037163).

Topics & Concepts

MedicineStenosisFractional flow reserveAngiographyComputed tomography angiographyVulnerable plaqueRadiologyAtheromaCardiologyRevascularizationMyocardial infarctionHazard ratioInternal medicineNuclear medicineCoronary angiographyConfidence intervalCerebrovascular and Carotid Artery DiseasesCoronary Interventions and DiagnosticsCardiac Imaging and Diagnostics