P2389Head-to-head comparison between framingham risk score, cacs, ccta, spect and hybrid spect/ccta in long-term prediction of major adverse cardiac events

Abstract Background There is existing evidence to suggest a correlation between coronary artery calcification (CAC) measured using ECG-triggered chest computed tomography and cardiovascular disease. Further evidence has emerged to suggest a correlation between CAC measured using non-gated CT scans and cardiovascular disease. Herein, we sought to ascertain the utility of incidental findings of CAC on non-triggered high resolution CT (HRCT) thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease and Framingham risk score (FRS) in predicting cardiovascular events. Methods The Computerised Radiology Information Service (CRIS) database was manually searched to determine all HRCT scans performed in a single trust from 05/2015 to 05/2016. The reports issued by Radiologists and images of selected studies were reviewed. For patients with CAC, we calculated the calcium score for patients using the Agatston method. Clinical events were determined from the electronic medical record without knowledge of patients' CAC findings. For these patients, the Framingham Risk Score (FRS) was also calculated. The primary end point of the study was composite of all-cause mortality and cardiac events (non-fatal myocardial infarction, coronary revascularization, new atrial fibrillation or heart failure episode requiring hospitalization). Results We selected 300 scans from a total of approximately 2000 scans performed over this time. Data at follow up was available for 100% of the patients, with a median duration of follow up of 1.6 years. Moderate to severe CAC was found in 35% of people. Multivariable analysis showed good concordance between CAC and FRS in predicting composite clinical end point. The Odds Ratio for cardiac events in patients with moderate to severe CAC was 5.3 (p<0.01) and for composite clinical end point was 3.4 (p<0.01). This is similar to the OR predicted by the FRS: 4.8; p<0.01 and 3.1; p<0.01 respectively. Only 6.2% of patients with moderate to severe CAC were currently statin treated. Conclusion In this retrospective study of patients with respiratory disease attending for HRCT scanning, co-incidentally detected CAC predicts cardiac events, with good concordance with the FRS. The incidental finding of CAC on non-gated CT scanning should be reported with Agatston score calculation allowing consideration of intervention to mitigate cardiovascular risk and optimize. Further multi-centre prospective studies of this strategy, with a larger patient cohort should be conducted to clarify the utility of CAC as a prediction tool to modify cardiac risk. Funding Acknowledgement Type of funding source: None

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IMPACT OF MYOCARDIAL BRIDGING ON MAJOR ADVERSE CARDIAC EVENTS: VERY LONG–TERM CLINICAL OUTCOMES FOLLOWING FIRST– AND SECOND–GENERATION DRUG–ELUTING STENT IMPLANTATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(13)61725-8 ◽

2013 ◽

Vol 61 (10) ◽

pp. E1725

Author(s):

Ryotaro Yamada ◽

Kenji Sakamoto ◽

Hideki Kitahara ◽

Paul Yock ◽

Peter Fitzgerald ◽

...

Keyword(s):

Clinical Outcomes ◽

Stent Implantation ◽

Major Adverse Cardiac Events ◽

Drug Eluting Stent ◽

Cardiac Events ◽

Myocardial Bridging ◽

Adverse Cardiac Events ◽

Drug Eluting ◽

First And Second Generation

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Factors associated with long-term major adverse cardiac events of coronary bioresorbable vascular scaffold

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-020-00723-w ◽

2021 ◽

Author(s):

Andrew Kei-Yan Ng ◽

Pauline Yeung Ng ◽

Chung-Wah Siu ◽

Man-Hong Jim

Keyword(s):

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Bioresorbable Vascular Scaffold ◽

Factors Associated ◽

Adverse Cardiac Events ◽

Vascular Scaffold

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Major Adverse Cardiac Events at Long-Term Follow-Up in Patients Treated With Single versus Multiple Stents during Single-Vessel Percutaneous Coronary Intervention

Journal of Interventional Cardiology ◽

10.1111/j.1540-8183.2009.00487.x ◽

2009 ◽

Vol 22 (5) ◽

pp. 427-430

Author(s):

RISHI SUKHIJA ◽

WILBERT S. ARONOW ◽

CHANDRASEKAR PALANISWAMY ◽

TARUNJIT SINGH ◽

CHUL AHN ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Adverse Cardiac Events ◽

Percutaneous Coronary ◽

Long Term Follow Up ◽

Single Versus

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LONG-TERM PREDICTION OF CARDIAC EVENTS IN ASYMPTOMATIC SUBJECTS BY INTEGRATING NOVEL CIRCULATING AND IMAGING BIOMARKERS USING MACHINE LEARNING

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)32207-5 ◽

2020 ◽

Vol 75 (11) ◽

pp. 1580

Author(s):

Andrew Lin ◽

Balaji Tamarappoo ◽

Frederic Commandeur ◽

Priscilla McElhinney ◽

Sebastien Cadet ◽

...

Keyword(s):

Machine Learning ◽

Imaging Biomarkers ◽

Cardiac Events ◽

Term Prediction ◽

Asymptomatic Subjects ◽

Long Term Prediction

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In situ skeletonized bilateral thoracic artery for left coronary circulation: a 20-year experience

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz138 ◽

2019 ◽

Vol 57 (1) ◽

pp. 160-167 ◽

Cited By ~ 1

Author(s):

Massimo Bonacchi ◽

Edvin Prifti ◽

Marco Bugetti ◽

Francesco Cabrucci ◽

Michael Cresci ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Circulation ◽

Artery Bypass ◽

Myocardial Revascularization ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Adverse Cardiac Events

Abstract OBJECTIVES Our goal was to analyse the outcomes in a patient population using a standardized technique for coronary artery bypass grafting (CABG) consisting of total arterial myocardial revascularization utilizing the in situ skeletonized bilateral thoracic artery for left coronary circulation. We also explored potential predictors of long-time unfavourable outcomes. METHODS Patients undergoing total arterial myocardial revascularization using in situ skeletonized bilateral thoracic artery for left coronary circulation between January 1997 and May 2017 were included prospectively in this study. The median follow-up (100% complete) was 103 months (interquartile range 61–189 months) and ranged from 1 to 245 months. RESULTS A total of 1325 consecutive patients were recruited. During the follow-up period, there were 131 deaths (9.8%), 146 repeat revascularizations (11.0%) and 229 major adverse cardiac events (17.2%). The 18-year freedom from major adverse cardiac events was 62.6 ± 9.3%, 62.5 ± 6.3% and 53.9 ± 11.0%, respectively. Multivariable models showed that a left ventricular ejection fraction ≤35%, chronic obstructive pulmonary disease, peripheral vascular disease (P < 0.001), chronic kidney disease and age ≥80 years (P = 0.002) were independent predictors of diminished long-term survival. Moreover, peripheral vascular disease and off-pump coronary artery bypass (both, P < 0.001) predicted repeat revascularization. Finally, age ≥80 years, peripheral vascular disease, left ventricular ejection fraction ≤35%, off-pump coronary artery bypass and chronic pulmonary obstructive disease were independent predictors of major adverse cardiac events during the long-term follow-up period (all, P < 0.001). CONCLUSIONS Coronary artery bypass using the in situ skeletonized bilateral thoracic artery for left coronary circulation configuration for total arterial myocardial revascularization resulted in satisfactory long-term results with a low incidence of death and late events and may represent a technique of choice in selected patients having CABG. Larger and long-term prospective studies are, however, warranted.

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