Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]

Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
American Heart Association (AHA)
Published 2018

Publication Date:	2018-01-17
Publisher:	American Heart Association (AHA)
Print ISSN:	1941-9651
Electronic ISSN:	1942-0080
Topics:	Medicine
Keywords:	Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease
Published by:	http://www.americanheart.org/

Staff View

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autor	Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
beschreibung	Background— Computed tomographic coronary angiography is a noninvasive imaging modality that permits identification and characterization of coronary plaques. Despite consensus statements supporting routine reporting of computed tomographic coronary angiography plaque characteristics, there remains uncertainty whether these data convey prognostic information. We performed a systematic review and meta-analysis assessing the strength of association between computed tomographic coronary angiography–derived plaque characterization and major adverse cardiovascular events (MACE). Methods and Results— Electronic databases were searched for studies reporting computed tomographic coronary angiography plaque characterization and MACE. Data were gathered on plaque morphology (noncalcified, partially calcified, and calcified) and high-risk plaque (HRP) features, including low-attenuation plaque, napkin-ring sign, spotty calcification, and positive remodeling. Of 5496 citations, 13 studies met inclusion criteria. Five hundred fifty-two (3.9%) MACE occurred in 13 977 patients with mean follow-up ranging between 1.3 and 8.2 years. In terms of plaque morphology, the strongest association was observed for noncalcified plaque (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.24–1.70; P 〈0.001), with weaker associations found for partially calcified (HR, 1.37; 95% CI, 1.18–1.60; P 〈0.001) and calcified plaques (HR, 1.23; 95% CI, 1.16–1.30; P 〈0.001). All HRP features were strongly associated with MACE, including napkin-ring sign (HR, 5.06; 95% CI, 3.23–7.94; P 〈0.001), low-attenuation plaque (HR, 2.95; 95% CI, 2.03–4.29; P 〈0.001), positive remodeling (HR, 2.58; 95% CI, 1.84–3.61; P 〈0.001), and spotty calcification (HR, 2.25; 95% CI, 1.26–4.04; P =0.006). The presence of ≥2 HRP features had highest risk of MACE (HR, 9.17; 95% CI, 4.10–20.50; P 〈0.001). Conclusions— These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications.
citation_standardnr	6139875
datenlieferant	ipn_articles
feed_id	109339
feed_publisher	American Heart Association (AHA)
feed_publisher_url	http://www.americanheart.org/
insertion_date	2018-01-17
journaleissn	1942-0080
journalissn	1941-9651
publikationsjahr_anzeige	2018
publikationsjahr_facette	2018
publikationsjahr_intervall	7984:2015-2019
publikationsjahr_sort	2018
publisher	American Heart Association (AHA)
quelle	Circulation: Cardiovascular Imaging
relation	http://circimaging.ahajournals.org/cgi/content/short/11/1/e006973?rss=1
schlagwort	Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease
search_space	articles
shingle_author_1	Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
shingle_author_2	Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
shingle_author_3	Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
shingle_author_4	Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J.
shingle_catch_all_1	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease] Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease Background— Computed tomographic coronary angiography is a noninvasive imaging modality that permits identification and characterization of coronary plaques. Despite consensus statements supporting routine reporting of computed tomographic coronary angiography plaque characteristics, there remains uncertainty whether these data convey prognostic information. We performed a systematic review and meta-analysis assessing the strength of association between computed tomographic coronary angiography–derived plaque characterization and major adverse cardiovascular events (MACE). Methods and Results— Electronic databases were searched for studies reporting computed tomographic coronary angiography plaque characterization and MACE. Data were gathered on plaque morphology (noncalcified, partially calcified, and calcified) and high-risk plaque (HRP) features, including low-attenuation plaque, napkin-ring sign, spotty calcification, and positive remodeling. Of 5496 citations, 13 studies met inclusion criteria. Five hundred fifty-two (3.9%) MACE occurred in 13 977 patients with mean follow-up ranging between 1.3 and 8.2 years. In terms of plaque morphology, the strongest association was observed for noncalcified plaque (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.24–1.70; P <0.001), with weaker associations found for partially calcified (HR, 1.37; 95% CI, 1.18–1.60; P <0.001) and calcified plaques (HR, 1.23; 95% CI, 1.16–1.30; P <0.001). All HRP features were strongly associated with MACE, including napkin-ring sign (HR, 5.06; 95% CI, 3.23–7.94; P <0.001), low-attenuation plaque (HR, 2.95; 95% CI, 2.03–4.29; P <0.001), positive remodeling (HR, 2.58; 95% CI, 1.84–3.61; P <0.001), and spotty calcification (HR, 2.25; 95% CI, 1.26–4.04; P =0.006). The presence of ≥2 HRP features had highest risk of MACE (HR, 9.17; 95% CI, 4.10–20.50; P <0.001). Conclusions— These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications. Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J. American Heart Association (AHA) 1941-9651 19419651 1942-0080 19420080
shingle_catch_all_2	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease] Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease Background— Computed tomographic coronary angiography is a noninvasive imaging modality that permits identification and characterization of coronary plaques. Despite consensus statements supporting routine reporting of computed tomographic coronary angiography plaque characteristics, there remains uncertainty whether these data convey prognostic information. We performed a systematic review and meta-analysis assessing the strength of association between computed tomographic coronary angiography–derived plaque characterization and major adverse cardiovascular events (MACE). Methods and Results— Electronic databases were searched for studies reporting computed tomographic coronary angiography plaque characterization and MACE. Data were gathered on plaque morphology (noncalcified, partially calcified, and calcified) and high-risk plaque (HRP) features, including low-attenuation plaque, napkin-ring sign, spotty calcification, and positive remodeling. Of 5496 citations, 13 studies met inclusion criteria. Five hundred fifty-two (3.9%) MACE occurred in 13 977 patients with mean follow-up ranging between 1.3 and 8.2 years. In terms of plaque morphology, the strongest association was observed for noncalcified plaque (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.24–1.70; P <0.001), with weaker associations found for partially calcified (HR, 1.37; 95% CI, 1.18–1.60; P <0.001) and calcified plaques (HR, 1.23; 95% CI, 1.16–1.30; P <0.001). All HRP features were strongly associated with MACE, including napkin-ring sign (HR, 5.06; 95% CI, 3.23–7.94; P <0.001), low-attenuation plaque (HR, 2.95; 95% CI, 2.03–4.29; P <0.001), positive remodeling (HR, 2.58; 95% CI, 1.84–3.61; P <0.001), and spotty calcification (HR, 2.25; 95% CI, 1.26–4.04; P =0.006). The presence of ≥2 HRP features had highest risk of MACE (HR, 9.17; 95% CI, 4.10–20.50; P <0.001). Conclusions— These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications. Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J. American Heart Association (AHA) 1941-9651 19419651 1942-0080 19420080
shingle_catch_all_3	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease] Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease Background— Computed tomographic coronary angiography is a noninvasive imaging modality that permits identification and characterization of coronary plaques. Despite consensus statements supporting routine reporting of computed tomographic coronary angiography plaque characteristics, there remains uncertainty whether these data convey prognostic information. We performed a systematic review and meta-analysis assessing the strength of association between computed tomographic coronary angiography–derived plaque characterization and major adverse cardiovascular events (MACE). Methods and Results— Electronic databases were searched for studies reporting computed tomographic coronary angiography plaque characterization and MACE. Data were gathered on plaque morphology (noncalcified, partially calcified, and calcified) and high-risk plaque (HRP) features, including low-attenuation plaque, napkin-ring sign, spotty calcification, and positive remodeling. Of 5496 citations, 13 studies met inclusion criteria. Five hundred fifty-two (3.9%) MACE occurred in 13 977 patients with mean follow-up ranging between 1.3 and 8.2 years. In terms of plaque morphology, the strongest association was observed for noncalcified plaque (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.24–1.70; P <0.001), with weaker associations found for partially calcified (HR, 1.37; 95% CI, 1.18–1.60; P <0.001) and calcified plaques (HR, 1.23; 95% CI, 1.16–1.30; P <0.001). All HRP features were strongly associated with MACE, including napkin-ring sign (HR, 5.06; 95% CI, 3.23–7.94; P <0.001), low-attenuation plaque (HR, 2.95; 95% CI, 2.03–4.29; P <0.001), positive remodeling (HR, 2.58; 95% CI, 1.84–3.61; P <0.001), and spotty calcification (HR, 2.25; 95% CI, 1.26–4.04; P =0.006). The presence of ≥2 HRP features had highest risk of MACE (HR, 9.17; 95% CI, 4.10–20.50; P <0.001). Conclusions— These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications. Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J. American Heart Association (AHA) 1941-9651 19419651 1942-0080 19420080
shingle_catch_all_4	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease] Computerized Tomography (CT), Meta Analysis, Atherosclerosis, Coronary Artery Disease Background— Computed tomographic coronary angiography is a noninvasive imaging modality that permits identification and characterization of coronary plaques. Despite consensus statements supporting routine reporting of computed tomographic coronary angiography plaque characteristics, there remains uncertainty whether these data convey prognostic information. We performed a systematic review and meta-analysis assessing the strength of association between computed tomographic coronary angiography–derived plaque characterization and major adverse cardiovascular events (MACE). Methods and Results— Electronic databases were searched for studies reporting computed tomographic coronary angiography plaque characterization and MACE. Data were gathered on plaque morphology (noncalcified, partially calcified, and calcified) and high-risk plaque (HRP) features, including low-attenuation plaque, napkin-ring sign, spotty calcification, and positive remodeling. Of 5496 citations, 13 studies met inclusion criteria. Five hundred fifty-two (3.9%) MACE occurred in 13 977 patients with mean follow-up ranging between 1.3 and 8.2 years. In terms of plaque morphology, the strongest association was observed for noncalcified plaque (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.24–1.70; P <0.001), with weaker associations found for partially calcified (HR, 1.37; 95% CI, 1.18–1.60; P <0.001) and calcified plaques (HR, 1.23; 95% CI, 1.16–1.30; P <0.001). All HRP features were strongly associated with MACE, including napkin-ring sign (HR, 5.06; 95% CI, 3.23–7.94; P <0.001), low-attenuation plaque (HR, 2.95; 95% CI, 2.03–4.29; P <0.001), positive remodeling (HR, 2.58; 95% CI, 1.84–3.61; P <0.001), and spotty calcification (HR, 2.25; 95% CI, 1.26–4.04; P =0.006). The presence of ≥2 HRP features had highest risk of MACE (HR, 9.17; 95% CI, 4.10–20.50; P <0.001). Conclusions— These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications. Nerlekar, N., Ha, F. J., Cheshire, C., Rashid, H., Cameron, J. D., Wong, D. T., Seneviratne, S., Brown, A. J. American Heart Association (AHA) 1941-9651 19419651 1942-0080 19420080
shingle_title_1	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
shingle_title_2	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
shingle_title_3	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
shingle_title_4	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
timestamp	2025-06-30T23:32:04.178Z
titel	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
titel_suche	Computed Tomographic Coronary Angiography-Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis [Coronary Artery Disease]
topic	WW-YZ
uid	ipn_articles_6139875