Prognostic value of noninvasive combined anatomic/functional assessment by cardiac CT in patients with suspected coronary artery disease — Comparison with invasive coronary angiography and nuclear myocardial perfusion imaging for the five-year-follow up of the CORE320 multicenter study

Dewey, Marc; Rochitte, Carlos Eduardo; Ostovaneh, Mohammad Reza; Chen, Marcus Y; George, Richard Т. De; Niinuma, Hiroyuki; Kitagawa, Kakuya; Laham, Roger J.; Kofoed, Klaus F.; Nomura, César Higa; Sakuma, Hajime; Yoshioka, Kunihiro; Mehra, Vishal C.; Jinzaki, Masahiro; Kuribayashi, Sachio; Laule, Michael; Paul, Narinder; Scholte, Arthur J.; Cerci, Rodrigo; Hoe, John; Tan, Swee Yaw; Rybicki, Frank J.; Matheson, Matthew B.; Vavere, Andrea L.; Arai, Andrew E; Miller, Julie M.; Cox, Christopher; Brinker, Jeffrey A.; Clouse, Melvin E.; Carli, Marcelo Di; Lima, João A.C.; Arbab‐Zadeh, Armin

doi:10.1016/j.jcct.2021.04.005

Cited by 11 publications

(6 citation statements)

References 21 publications

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“…All included studies reported data on MACEs (12)(13)(14)(15)(16)(17). Four of the six studies assessed all-cause death during follow-up (13)(14)(15)(16).…”

Section: Pooled Results Of the Meta-analysismentioning

confidence: 99%

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Comparison of prognosis between coronary computed tomography angiography versus invasive coronary angiography for stable coronary artery disease: a systematic review and meta-analysis

Xie

Zhou

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe impact of using invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) as an initial examination on the incidence of major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease and the occurrence of major operation-related complications is uncertain.ObjectiveThis study aimed to explore the effects of ICA vs. CCTA on MACEs, all-cause death, and major operation-related complications.MethodsA systematic search of electronic databases (PubMed and Embase) was conducted for randomized controlled trials and observational studies comparing MACEs between ICA and CCTA from January 2012 to May 2022. The primary outcome measure was analyzed using a random-effects model as a pooled odds ratio (OR). The main observations were MACEs, all-cause death, and major operation-related complications.ResultsA total of six studies, comprising 26,548 patients, met the inclusion criteria (ICA n = 8,472; CCTA n = 18,076). There were statistically significant differences between ICA and CCTA for MACE [OR 1.37; 95% confidence interval (CI), 1.06–1.77; p = 0.02], all-cause death (OR 1.56; 95% CI, 1.38–1.78; p < 0.00001), and major operation-related complications (OR 2.10; 95% CI, 1.23–3.61; p = 0.007) among patients with stable coronary artery disease. Subgroup analysis demonstrated statistically significant results in the impact of ICA or CCTA on MACEs according to the length of follow-up. Compared to CCTA, ICA was related to a higher incidence of MACEs in the subgroup with a short follow-up (≤3 years) (OR 1.74; 95% CI, 1.54–1.96; p < 0.00001).ConclusionsAmong patients with stable coronary artery disease, an initial examination with ICA was significantly associated with the risk of MACEs, all-cause death, and major procedure-related complications compared to CCTA in this meta-analysis.

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“…All included studies reported data on MACEs (12)(13)(14)(15)(16)(17). Four of the six studies assessed all-cause death during follow-up (13)(14)(15)(16).…”

Section: Pooled Results Of the Meta-analysismentioning

confidence: 99%

“…Another 672 trials were excluded after reviewing the full text, as they failed to fulfill the inclusion criteria. Finally, we included 6 clinical trials for the purpose of analysis (12)(13)(14)(15)(16)(17). Data from 26,548 patients were available for the meta-analysis.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Comparison of prognosis between coronary computed tomography angiography versus invasive coronary angiography for stable coronary artery disease: a systematic review and meta-analysis

Xie

Zhou

et al. 2023

Front. Cardiovasc. Med.

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“…However, there is a discrepancy between angiographic severity and myocardial ischemia [ 30 ]. In addition, several thousand patients suffer adverse events from ICA annually [ 31 ]. Our ROC analyses suggested the importance of nutritional assessment before the performance of ICA, not only for strengthening the capacity of angiographic severity detected by ICA to predict the long-time cardiovascular outcome but also for the risk stratification and reference for the following appropriate management plan.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nutritional Index and Major Cardiovascular Events in Patients Undergoing Invasive Coronary Angiography: A Clinical Retrospective Study

Sang

Chen

et al. 2022

JPM

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We aimed to examine whether prognostic nutritional index (PNI) could serve as an auxiliary predictor for major cardiovascular events (MCEs) in patients undergoing invasive coronary angiography (ICA). A total of 485 participants were enrolled, divided into low-PNI (≥47.40) and high-PNI (<47.40) groups. ICA determined the stenotic vessels of coronary artery disease. The primary outcome was incidental MCEs, a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or rehospitalization of in-stent restenosis. There were 47 (9.69%) MCEs during the 3.78-years follow-up. The cumulative incidence of MCEs was significantly higher in the low-PNI patients compared with the high-PNI patients (17.07% vs. 7.18%, p = 0.001). Malnutrition risk (low PNI) was significantly and independently associated with a higher risk of MCEs (hazard ratios: 2.593, 95% confidence intervals [CI]: 1.418–4.742). Combined use of the number of stenotic vessels with malnutrition risk showed a higher capacity to predict the MCEs than the presence of stenotic vessels alone (areas under the receiver operator characteristic curve: 0.696 [95% CI, 0.618–0.775] vs. 0.550 [95% CI, 0.466–0.633], p = 0.013). In conclusion, lower PNI levels may predict a higher risk of cardiovascular events in patients undergoing ICA, which supports the necessity of the risk assessment of nutrition status and guide the clinical treatment on strengthening nutritional support before ICA is performed, as well as nutritional intervention after ICA.

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“…In the PERFECTION (PERfusion Versus Fractional Flow Reserve CT 39 . The Core320 (Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320 Detector Computed Tomography) study compared the prognostic value of a combined anatomical/functional assessment by non-invasive imaging versus a traditional approach, showing that 5-year MACE (cardiac death, MI, hospitalisation for chest pain or congestive heart failure, and late revascularisation)-free survival rates were greater among patients with normal findings of combined CCTA-CTP compared to ICA-SPECT: 85% vs 80% (95% CI for difference: 0.1-11.3) 40 .…”

Section: Static Stress Ctpmentioning

confidence: 99%

Computed tomographic angiography in coronary artery disease

Serruys¹,

Kotoku²,

Nørgaard³

et al. 2023

EuroIntervention

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Coronary computed tomographic angiography (CCTA) is becoming the first-line investigation for establishing the presence of coronary artery disease and, with fractional flow reserve (FFR CT ), its haemodynamic significance. In patients without significant epicardial obstruction, its role is either to rule out atherosclerosis or to detect subclinical plaque that should be monitored for plaque progression/regression following prevention therapy and provide risk classification. Ischaemic non-obstructive coronary arteries are also expected to be assessed by non-invasive imaging, including CCTA. In patients with significant epicardial obstruction, CCTA can assist in planning revascularisation by determining the disease complexity, vessel size, lesion length and tissue composition of the atherosclerotic plaque, as well as the best fluoroscopic viewing angle; it may also help in selecting adjunctive percutaneous devices (e.g., rotational atherectomy) and in determining the best landing zone for stents or bypass grafts.

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Prognostic value of noninvasive combined anatomic/functional assessment by cardiac CT in patients with suspected coronary artery disease — Comparison with invasive coronary angiography and nuclear myocardial perfusion imaging for the five-year-follow up of the CORE320 multicenter study

Cited by 11 publications

References 21 publications

Comparison of prognosis between coronary computed tomography angiography versus invasive coronary angiography for stable coronary artery disease: a systematic review and meta-analysis

Comparison of prognosis between coronary computed tomography angiography versus invasive coronary angiography for stable coronary artery disease: a systematic review and meta-analysis

Prognostic Nutritional Index and Major Cardiovascular Events in Patients Undergoing Invasive Coronary Angiography: A Clinical Retrospective Study

Computed tomographic angiography in coronary artery disease

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