ArticleEuropean radiology2023
Prognostic value of CT-derived coronary artery disease characteristics varies by ASCVD risk: insights from the PROMISE trial.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Age and sex specific coronary plaque characteristics among South Asians: Insights from the DILWALE CTA study.American journal of preventive cardiology · 2026Article
- Prognostic impact of epicardial fat volume, anatomical and functional imaging across the cardiovascular risk spectrum in patients with suspected coronary artery disease: a single-center retrospective cohort study.Quantitative imaging in medicine and surgery · 2026Article
- Biological Cardiovascular Age Derived from Coronary CTA Reports Using a Large Language Model: A Novel Predictor of Major Adverse Cardiovascular Events?Diagnostics (Basel, Switzerland) · 2026Article
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- Development of a MACE risk prediction model based on CCTA-derived quantitative parameters: a proof-of-concept study.Frontiers in cardiovascular medicine · 2026Article
- AI-Quantitative CT Coronary Plaque Features Associate With a Higher Relative Risk in Women: CONFIRM2 Registry.Circulation. Cardiovascular imaging · 2025Observational
- Coronary computed tomography angiography in primary care patients with chest pain or dyspnea - a cross-sectional study.BMC primary care · 2025Article
- Whys and Wherefores of Coronary Arterial Positive Remodeling.Arteriosclerosis, thrombosis, and vascular biology · 2024Review
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- Coronary Computed Tomography Angiography (CTA) in the Diagnostic Triage of Patients Undergoing Liver Transplantation: A Long-term Outcome Study.Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
objectivesTo compare the prognostic value of individual CT-derived coronary artery disease (CAD) characteristics across categories of clinical cardiovascular risk.
methodsThe central core laboratory assessed coronary artery calcium (CAC), obstructive CAD (stenosis ≥ 50%), and high-risk plaque (HRP) in stable outpatients with suspected CAD enrolled in the PROMISE trial. Multivariable Cox regression models (endpoint: unstable angina, nonfatal myocardial infarction, or all-cause mortality; median follow-up: 2 years) were used to compare hazard ratios (HR) of the CT measures between low-borderline (< 7.5%) and moderate-high (≥ 7.5%) atherosclerotic cardiovascular disease (ASCVD) risk based on the pooled cohort equation.
resultsAmong 4356 included patients (aged 61 ± 8 years, 52% women), 67% had ASCVD risk ≥ 7.5%. Stratified by ASCVD risk, CAD ≥ 50% had nearly threefold greater HR in individuals with ASCVD < 7.5% (aHR, 6.85; 95% CI, 2.33-20.15; p < 0.001) vs. ASCVD ≥ 7.5% (aHR: 2.66, 95% CI: 1.67-4.25, p < 0.001; interaction p = 0.041). CAC predicted events solely in ASCVD ≥ 7.5% patients (aHR: 1.92, 95% CI: 1.01-3.63, p = 0.045; interaction p = 0.571), while HRP predicted events only in ASCVD < 7.5% (aHR: 3.11, 95% CI: 1.09-8.85, p = 0.034; interaction p = 0.034).
conclusionsPrognostic values of CT-derived CAD characteristics differ by ASCVD risk categories. While CAD ≥ 50% has the highest prognostic value regardless of ASCVD risk, CAC is prognostic in high and HRP in low ASCVD risk. These findings suggest that CAD ≥ 50% and HRP detection rather than CAC scoring may better risk-stratify symptomatic low-risk patients and thus potentially improve downstream care. KEY POINTS: • Prognostic value of individual CT-derived CAD characteristics differs by categories of cardiovascular risk. • Presence of obstructive coronary artery stenosis ≥ 50% has the highest prognostic value regardless of cardiovascular risk. • Coronary artery calcium is independently prognostic in high and high-risk plaque features in low cardiovascular risk.
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