scholarly journals TCTAP C-229 Acute Coronary Syndrome Due to LAD Myocardial Bridging Treated with Self-expandable Balloon Releasable DES (Stentys X-position): Coronary Computed Tomography Angiography, FFR and IVUS Guided Procedure

2016 ◽  
Vol 67 (16) ◽  
pp. S380-S382
Author(s):  
Farhat Fouladvand
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Myocardial Bridging ◽  
Coronary Computed Tomography ◽  
Coronary Syndrome

scholarly journals Prediction of acute coronary syndrome within 3 years using radiomics signature of pericoronary adipose tissue based on coronary computed tomography angiography

2021 ◽  
Author(s):  
Jin Shang ◽  
Shaowei Ma ◽  
Yan Guo ◽  
Linlin Yang ◽  
Qian Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Adipose Tissue ◽  
Computed Tomography Angiography ◽  
Predictive Models ◽  
Coronary Computed Tomography Angiography ◽  
Plaque Score ◽  
Coronary Computed Tomography ◽  
Coronary Syndrome ◽  
Radiomics Signature

Abstract Objectives To evaluate whether radiomics signature of pericoronary adipose tissue (PCAT) based on coronary computed tomography angiography (CCTA) could improve the prediction of future acute coronary syndrome (ACS) within 3 years. Methods We designed a retrospective case-control study that patients with ACS (n = 90) were well matched to patients with no cardiac events (n = 1496) during 3 years follow-up, then which were randomly divided into training and test datasets with a ratio of 3:1. A total of 107 radiomics features were extracted from PCAT surrounding lesions and 14 conventional plaque characteristics were analyzed. Radiomics score, plaque score, and integrated score were respectively calculated via a linear combination of the selected features, and their performance was evaluated with discrimination, calibration, and clinical application. Results Radiomics score achieved superior performance in identifying patients with future ACS within 3 years in both training and test datasets (AUC = 0.826, 0.811) compared with plaque score (AUC = 0.699, 0.640), with a significant difference of AUC between two scores in the training dataset (p = 0.009); while the improvement of integrated score discriminating capability (AUC = 0.838, 0.826) was non-significant. The calibration curves of three predictive models demonstrated a good fitness respectively (all p > 0.05). Decision curve analysis suggested that integrated score added more clinical benefit than plaque score. Stratified analysis revealed that the performance of three predictive models was not affected by tube voltage, CT version, different sites of hospital. Conclusion CCTA-based radiomics signature of PCAT could have the potential to predict the occurrence of subsequent ACS. Radiomics-based integrated score significantly outperformed plaque score in identifying future ACS within 3 years. Key Points • Plaque score based on conventional plaque characteristics had certain limitations in the prediction of ACS. • Radiomics signature of PCAT surrounding plaques could have the potential to improve the predictive ability of subsequent ACS. • Radiomics-based integrated score significantly outperformed plaque score in the identification of future ACS within 3 years.

scholarly journals HEART score improves efficiency of coronary computed tomography angiography in patients suspected of acute coronary syndrome in the emergency department

2019 ◽  
Vol 9 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Murat Arslan ◽  
Jeroen Schaap ◽  
Pleunie PM Rood ◽  
Koen Nieman ◽  
Ricardo PJ Budde ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Coronary Computed Tomography ◽  
Heart Score ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events

Aims: Coronary computed tomography angiography is increasingly employed in the emergency department for suspected acute coronary syndrome patients. The HEART score has been proposed for initial risk stratification in these patients. The aim of this study was to investigate the diagnostic value and efficiency of the HEART score before coronary computed tomography angiography. Methods and results: We included patients suspected of acute coronary syndrome who underwent coronary computed tomography angiography in the emergency department. Based on the HEART score, patients were stratified as low-risk (HEART≤3), intermediate-risk (HEART4–6) and high-risk (HEART≥7). We assessed coronary computed tomography angiography for the presence of significant coronary artery disease (>50% stenosis). The primary outcome, the level of major adverse cardiac events, was a composite endpoint of all-cause mortality, acute coronary syndrome or coronary revascularisation within 30 days. The study population consisted of 340 patients (mean age: 55.6±10.1 years, 44.7% women), major adverse cardiac events occurred in 45 (13.2%) patients. The incidence of major adverse cardiac events in patients stratified as low-risk (35.0%), intermediate-risk (56.8%) and high-risk (8.2%) was 3.4%, 12.4% and 60.7%, respectively. All four low-risk patients with major adverse cardiac events had a HEART score of three. An algorithm where coronary computed tomography angiography is reserved for patients with HEART 3–6 resulted in a sensitivity of 97.8%, specificity of 84.1%, negative predictive value of 99.6% and positive predictive value of 48.4%, while reducing the need for coronary computed tomography angiography by 22% ( n=75). Conclusion: The predictive value of coronary computed tomography angiography for 30-day major adverse cardiac events in suspected acute coronary syndrome patients is good, and reserving coronary computed tomography angiography for HEART score 3–6 patients reduces the number of needed coronary computed tomography angiograms without affecting diagnostic accuracy.

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