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Schaab JA, Candreva A, Rossi A, Markendorf S, Sager D, Messerli M, Pazhenkottil AP, Benz DC, Kaufmann PA, Buechel RR, Stähli BE, Giannopoulos AA. A simple coronary CT angiography-based jeopardy score for the identification of extensive coronary artery disease: Validation against invasive coronary angiography. Diagn Interv Imaging 2024; 105:151-158. [PMID: 38007373 DOI: 10.1016/j.diii.2023.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE The invasive British Cardiovascular Intervention Society Jeopardy Score (iBCIS-JS) is a simple angiographic scoring system, enabling quantification of the extent of jeopardized myocardium related to clinically significant coronary artery disease (CAD). The purpose of this study was to develop and validate the coronary CT angiography-based BCIS-JS (CT-BCIS-JS) against the iBCIS-JS in patients with suspected or stable CAD. MATERIALS AND METHODS Patients who underwent coronary CT angiography followed by invasive coronary angiography, within 90 days were retrospectively included. CT-BCIS-JS and iBCIS-JS were calculated, with a score ≥ 6 indicating extensive CAD. Correlation between the CT-BCIS-JS and iBCIS-JS was searched for using Spearman's coefficient, and agreement with weighted Kappa (κ) analyses. RESULTS A total of 122 patients were included. There were 102 men and 20 women with a median age of 62 years (Q1, Q3: 54, 68; age range: 19-83 years). No differences in median CT-BCIS-JS (4; Q1, Q3: 0, 8) and median iBCIS-JS (4; Q1, Q3: 0, 8) were found (P = 0.18). Extensive CAD was identified in 53 (43.4%) and 52 (42.6%) patients using CT-BCIS-JS and iBCIS-JS, respectively (P = 0.88). CT-based and iBCIS-JS showed excellent correlation (r = 0.98; P < 0.001) and almost perfect agreement (κ = 0.93; 95% confidence interval: 0.90-0.97). Agreement for identification of an iBCIS-JS ≥ 6 was almost perfect (κ = 0.94; 95 % confidence interval: 0.87-0.99). CONCLUSION The CT-BCIS-JS represents a feasible, and accurate method for quantification of CAD, with capabilities not different from those of iBCIS-JS. It enables simple, non-invasive identification of patients with anatomically extensive CAD.
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Affiliation(s)
- Jan A Schaab
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Alessandro Candreva
- Department of Cardiology, University Heart Center, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Alexia Rossi
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Susanne Markendorf
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Dominik Sager
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland; Department of Cardiology, University Heart Center, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland; Department of Cardiology, University Heart Center, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Barbara E Stähli
- Department of Cardiology, University Heart Center, University Hospital Zurich, CH-8091 Zurich, Switzerland
| | - Andreas A Giannopoulos
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland.
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Belmonte M, Paolisso P, Gallinoro E, Bertolone DT, Caglioni S, Leone A, De Colle C, Viscusi MM, Bermpeis K, Storozhenko T, Mileva N, Sonck J, Wyffels E, Vanderheyden M, Collet C, De Bruyne B, Andreini D, Penicka M, Barbato E. Predictors of percutaneous coronary intervention derived from CCTA in patients with chronic coronary syndrome. J Cardiovasc Comput Tomogr 2024; 18:154-161. [PMID: 38238196 DOI: 10.1016/j.jcct.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/23/2023] [Accepted: 01/06/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND To identify anatomical and morphological plaque features predictors of PCI and create a multiparametric score to increase the predictive yield. Moreover, we assessed the incremental predictive value of FFRCT (Fractional Flow Reserve derived from CCTA) trans-lesion gradient (ΔFFRCT) when integrated into the score. METHODS Observational cohort study including patients undergoing CCTA for suspected coronary artery disease, with FFRCT available, referred to invasive coronary angiogram and assessment of fractional flow reserve. Plaque analysis was performed using validated semi-automated software. Logistic regression was performed to identify anatomical and morphological plaque features predictive of PCI. Optimal thresholds were defined by area under the receiver-operating characteristics curve (AUC) analysis. A scoring system was developed in a derivation cohort (70 % of the study population) and tested in a validation cohort (30 % of patients). RESULTS The overall study population included 340 patients (455 vessels), among which 238 patients (320 vessels) were included in the derivation cohort. At multivariate logistic regression analysis, absence of left main disease, diameter stenosis (DS), non-calcified plaque (NCP) volume, and percent atheroma volume (PAV) were independent predictors of PCI. Optimal thresholds were: DS ≥ 50 %, volume of NCP>113 mm3 and PAV>17 %. A weighted score (CT-PCI Score) ranging from 0 to 11 was obtained. The AUC of the score was 0.80 (95%CI 0.74-0.86). The integration of ΔFFRCT in the CT-PCI score led to a mild albeit not significant increase in the AUC (0.82, 95%CI 0.77-0.87, p = 0.328). CONCLUSIONS Plaque anatomy and morphology derived from CCTA could aid in identifying patients amenable to PCI.
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Affiliation(s)
- Marta Belmonte
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Pasquale Paolisso
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Dario Tino Bertolone
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Serena Caglioni
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Cona, Ferrara, Italy
| | - Attilio Leone
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | | | - Michele Mattia Viscusi
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | | | - Niya Mileva
- Specialized Cardiovascular Hospital "Medica Cor", Ruse, Bulgaria; Medical University of Sofia, Sofia, Bulgaria
| | - Jeroen Sonck
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | - Eric Wyffels
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | | | - Carlos Collet
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
| | - Bernard De Bruyne
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Daniele Andreini
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Martin Penicka
- Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
| | - Emanuele Barbato
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Clinical and Molecular Medicine, Sapienza University of Rome, Roma, Italy.
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Hideo-Kajita A, Garcia-Garcia HM, Rubarth R, Wopperer S, Ozaki Y, Freire AFD, Cavalcante R, Bittencourt M, Dan K, Pinheiro TL, Falcão BAA, Falcao JLA, Soares P, Ribeiro E, Rochitte CE, Lemos PA. Natural History of Adapted Leaman Score Assessing Coronary Artery Disease Progression by Computed Tomography Angiography: A 7-Year Follow-Up Report. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 27:38-44. [PMID: 33097462 DOI: 10.1016/j.carrev.2020.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/22/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Coronary computed tomographic angiography (CCTA) provides a non-invasive assessment of the coronary artery tree. Computed Tomography - adapted Leaman Score (CT-LeSc) has been shown to be an independent predictor of cardiac events in coronary artery disease (CAD) patients with a score greater than 5 (high). PURPOSE To investigate the relationship between CT-LeSc and the progression of CAD and to provide vessel- and segment-level CAD qualification and quantification at baseline and 7-year follow-up. METHODS Patients with multivessel CAD and CCTA assessments at baseline and follow-up were included. The CT-LeSc analysis was performed in a paired fashion. The patient-level scores and the differences between each phase were assessed by 2 analysts in an independent core laboratory. RESULTS This study analyzed 248 coronary segments from 17 patients with a mean follow-up interval of 7.5 ± 0.6 years. The mean CT-LeSc at baseline and follow-up were 14.6 ± 4.2 and 16.9 ± 1.5, respectively, with an absolute increase of 2.3 ± 1.8. The mean cumulative increase of new lesions was 0.2 ± 0.2 per year. Over time, 14.6% of the non-obstructive lesions became obstructive, and 15.0% of the non-calcified plaques became calcified. There were 29 new lesions found at follow-up, and out of these, 16 were obstructive and 19 were non-calcified. CONCLUSION In patients at high risk for cardiac events, as determined by CT-LeSc, there was an increase in CT-LeSc, obstructive lesions, and calcified plaques over the 7-year follow-up period. Most of the new lesions were obstructive and non-calcified. This is the first report showing long-term serial imaging CCTA changes in a high-risk population.
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Affiliation(s)
| | | | - Rodrigo Rubarth
- Georgetown University School of Medicine, Washington, DC, USA
| | - Samuel Wopperer
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | - Yuichi Ozaki
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | | | - Rafael Cavalcante
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Marcio Bittencourt
- Center for Clinical and Epidemiological Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Kazuhiro Dan
- MedStar Washington Hospital Center, Interventional Cardiology Department, USA
| | - Thais L Pinheiro
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | | | - Paulo Soares
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Expedito Ribeiro
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carlos E Rochitte
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Pedro Alves Lemos
- Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
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Correlation between computed tomography adapted leaman score and computed tomography liver and spleen attenuation parameters for non-alcoholic fatty liver disease as well as respective inflammatory mediators. Int J Cardiovasc Imaging 2020; 36:2383-2391. [DOI: 10.1007/s10554-020-02026-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/12/2020] [Indexed: 11/27/2022]
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Doucette K, Tian X, Chawla U, Jain NA, Chen M, Ito S, Bogaty P, Koklanaris E, Barrett J, Battiwalla M. Premature coronary artery disease following allogeneic stem cell transplantation: an NHLBI Cohort Study. Bone Marrow Transplant 2018; 54:320-322. [PMID: 30104719 DOI: 10.1038/s41409-018-0282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 05/29/2018] [Accepted: 06/16/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Kimberley Doucette
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA.
| | - Xin Tian
- Office of Biostatistics Research, NHLBI, National Institutes of Health, 6701 Rockledge Dr RKL2/9208, Bethesda, MD, 20892-7913, USA
| | - Upneet Chawla
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
| | - Natasha A Jain
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
| | - Marcus Chen
- NHLBI, National Institutes of Health, Cardiopulmonary Branch, 10 Center Drive MSC 1202, Bethesda, MD, 20892, USA
| | - Sawa Ito
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
| | - Peter Bogaty
- Quebec Heart and Lung Institute, Laval University, 2725, Chemin Sainte-Foy, Québec, QC, G1V 4G5, Canada
| | - Eleftheria Koklanaris
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
| | - John Barrett
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
| | - Minoo Battiwalla
- NHLBI, National Institutes of Health, Hematology Branch, 10 Center Drive MSC, Bethesda, MD, 20892, USA
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Baumann S, Kryeziu P, Rutsch M, Lossnitzer D. Coronary Computed Tomography Angiography. Interv Cardiol 2017. [DOI: 10.5772/67800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Role of Intravascular Ultrasound in the Detection of Cardiovascular Disease in Diabetes and Metabolic Syndrome in Latin America. CURRENT CARDIOVASCULAR IMAGING REPORTS 2016. [DOI: 10.1007/s12410-016-9395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mangili LC, Mangili OC, Bittencourt MS, Miname MH, Harada PH, Lima LM, Rochitte CE, Santos RD. Epicardial fat is associated with severity of subclinical coronary atherosclerosis in familial hypercholesterolemia. Atherosclerosis 2016; 254:73-77. [DOI: 10.1016/j.atherosclerosis.2016.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 12/22/2022]
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