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- W2167566340 abstract "In this single-centered, retrospective cohort study of 458 low-to-intermediate-risk patients presenting with acute onset chest pain and without acute coronary syndrome or non-cardiac etiology of their symptoms on initial work-up, the authors investigated the value of coronary artery calcium (CAC) score and cardiac computed tomography (CT) angiography in predicting the risk for major adverse coronary events (MACE). Of the 458 patients included in the analysis, 70 (15%) had a MACE during the 24-month follow-up period. Here MACE was defined by cardiac death (due to myocardial infarction, heart failure, or dysrhythmia), non-fatal myocardial infarction, unstable angina, or need for revascularization procedure (coronary artery bypass graft or percutaneous coronary intervention). In patients without atherosclerotic plaque seen on CT angiography, there were zero adverse events. Among patients with CAC scores of zero, 5% experienced adverse cardiac events. Among patients without coronary artery stenosis on CT angiography, 10% experienced a MACE. One hundred percent of patients with MACE had atherosclerotic plaques by CT angiography, whereas 59% of patients without MACE had atherosclerotic plaques. Of patients with MACE and atherosclerotic plaque, 74% demonstrated mixed calcified and non-calcified disease, whereas exclusively calcified and exclusively non-calcified plaques represent 9% and 17% of atherosclerotic disease associated with MACE. Overall, lack of atherosclerotic plaque by CT angiography seemed to be sufficient to rule out coronary artery disease (CAD) in this low-to-intermediate-risk population; whereas neither negative CAC nor lack of coronary artery stenosis was sufficient to rule out CAD in this population. In patients who go on to develop adverse coronary events, multiple segments of atherosclerotic plaque and mixed atherosclerotic disease incur increasing risk for an adverse event. Although increasing CAC score and coronary artery stenosis seen by CT angiography generally correspond to increasing risk of MACE, they do not reliably predict adverse coronary events." @default.
- W2167566340 created "2016-06-24" @default.
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- W2167566340 date "2012-12-01" @default.
- W2167566340 modified "2023-09-27" @default.
- W2167566340 title "Incremental Prognostic Value of Different Components of Coronary Atherosclerotic Plaque at Cardiac CT Angiography beyond Coronary Calcification in Patients with Acute Chest Pain" @default.
- W2167566340 doi "https://doi.org/10.1016/j.jemermed.2012.10.012" @default.
- W2167566340 hasPublicationYear "2012" @default.
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