Observational studyJACC. Cardiovascular imaging2019
Superior Risk Stratification With Coronary Computed Tomography Angiography Using a Comprehensive Atherosclerotic Risk Score.
Observational study in JACC. Cardiovascular imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04186676 (Myocardial Infarction With Non-Obstructive Coronary Arteries in the Greek Population), which is not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Myocardial Infarction With Non-Obstructive Coronary Arteries in the Greek Population: Diagnosis and Management (The MINOCA-GR Registry)
Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Coronary CT angiography alone versus with CT perfusion: a systematic review and meta-analysis assessing approaches for chest pain.European radiology · 2025Pooled it
- SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography.Journal of cardiovascular computed tomographyGuideline
- Plasma lipidomics and coronary plaque changes: a substudy of the SMARTool clinical trial.European heart journal. Cardiovascular Imaging · 2024Trial
- Blood Monocyte Phenotype Fingerprint of Stable Coronary Artery Disease: A Cross-Sectional Substudy of SMARTool Clinical Trial.BioMed research international · 2020Trial
- Non-invasive identification of high-risk plaques in non-culprit lesions of acute coronary syndrome.Heart and vessels · 2026Article
- Real-world insights into coronary CTA prognostication: value of semiquantitative scores.La Radiologia medica · 2026Article
- Advancing Coronary Risk Assessment Through Combined Radiomic, Mechanical, and Hemodynamic Analysis.Annals of biomedical engineering · 2026Article
- CT-derived fractional flow reserve combined with atherosclerotic extent to determine long-term outcomes in diabetic patients with coronary artery disease.Journal of geriatric cardiology : JGC · 2026Article
- Residual coronary atherosclerotic risk and low LDL-cholesterol in chronic coronary syndromes.European heart journal. Imaging methods and practice · 2026Article
- Article
- Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Lipomatous Hypertrophy of the Interatrial Septum (LHIS) a Biomarker for Cardiovascular Protection? A Hypothesis Generating Case-Control Study.Journal of cardiovascular development and disease · 2025Article
- Incremental value of physiological indices to predict high-risk plaques detected by NIRS-IVUS.Cardiovascular intervention and therapeutics · 2025Article
- Prognostic value of coronary plaque composition in symptomatic patients with obstructive coronary artery disease.European radiology · 2025Article
- Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study.Scientific reports · 2025Observational
- Pericoronary adipose tissue attenuation on coronary computed tomography angiography: Possibilities and challenges.Atherosclerosis · 2025Article
- Prognostic Significance of Computed Tomography-Derived Fractional Flow Reserve for Long-Term Outcomes in Individuals With Coronary Artery Disease.Journal of the American Heart Association · 2025Article
- Health improvements by understanding residual risk in coronary artery disease and new targets for prevention/treatment: rationale and research protocol of the HURRICANE project.European heart journal open · 2025Article
- The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Review
- Patient-Specific Myocardial Infarction Risk Thresholds From AI-Enabled Coronary Plaque Analysis.Circulation. Cardiovascular imaging · 2024Article
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Authors and funding
37 authors.
Funding
Abstract
objectivesThis study was designed to assess the prognostic value of a new comprehensive coronary computed tomography angiography (CTA) score compared with the stenosis severity component of the Coronary Artery Disease-Reporting and Data System (CAD-RADS).
backgroundCurrent risk assessment with coronary CTA is mainly focused on maximal stenosis severity. Integration of plaque extent, location, and composition in a comprehensive model may improve risk stratification.
methodsA total of 2,134 patients with suspected but without known CAD were included. The predictive value of the comprehensive CTA score (ranging from 0 to 42 and divided into 3 groups: 0 to 5, 6 to 20, and >20) was compared with the CAD-RADS combined into 3 groups (0% to 30%, 30% to 70% and ≥70% stenosis). Its predictive performance was internally and externally validated (using the 5-year follow-up dataset of the CONFIRM [Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry], n = 1,971).
resultsThe mean age of patients was 55 ± 13 years, mean follow-up 3.6 ± 2.8 years, and 130 events (myocardial infarction or death) occurred. The new, comprehensive CTA score showed strong and independent predictive value using the Cox proportional hazard analysis. A model including clinical variables plus comprehensive CTA score showed better discrimination of events compared with a model consisting of clinical variables plus CAD-RADS (0.768 vs. 0.742, p = 0.001). Also, the comprehensive CTA score correctly reclassified a significant proportion of patients compared with the CAD-RADS (net reclassification improvement 12.4%, p < 0.001). Good predictive accuracy was reproduced in the external validation cohort.
conclusionsThe new comprehensive CTA score provides better discrimination and reclassification of events compared with the CAD-RADS score based on stenosis severity only. The score retained similar prognostic accuracy when externally validated. Anatomic risk scores can be improved with the addition of extent, location, and compositional measures of atherosclerotic plaque. (Comprehensive CTA risk score calculator is available at: http://18.224.14.19/calcApp/).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.