ArticleEuropean radiology2024
Progression of non-obstructive coronary plaque: a practical CCTA-based risk score from the PARADIGM registry.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Prediction and critical feature analysis for coronary artery calcification progression.Medical & biological engineering & computing · 2026Article
- Cardiac CT in the Era of Precision Cardiology: From Calcium Scoring to Comprehensive Risk Profiling.Journal of clinical medicine · 2026Review
- Coronary Computed Tomography Angiography for the Diagnosis and Revascularization Guidance of Coronary Bifurcation Lesions: A Contemporary Review.Journal of clinical medicine · 2026Review
- Cardiac Computed Tomography: Technological Developments and Clinical Applications.Journal of cardiovascular development and disease · 2025Review
- Suboptimal Control of Small Dense Low-Density Lipoprotein Cholesterol Is Associated With Coronary Plaque Progression: An Intravascular Ultrasound Study.Journal of the American Heart Association · 2025Article
- The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Review
- Beyond Stress Ischemia: Unveiling the Multifaceted Nature of Coronary Vulnerable Plaques Using Cardiac Computed Tomography.Journal of clinical medicine · 2024Review
- The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes.Journal of clinical medicine · 2024Review
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Authors and funding
39 authors at 20 institutions in 9 countries.
Funding
Abstract
objectivesNo clear recommendations are endorsed by the different scientific societies on the clinical use of repeat coronary computed tomography angiography (CCTA) in patients with non-obstructive coronary artery disease (CAD). This study aimed to develop and validate a practical CCTA risk score to predict medium-term disease progression in patients at a low-to-intermediate probability of CAD.
methodsPatients were part of the Progression of AtheRosclerotic PlAque Determined by Computed Tomographic Angiography Imaging (PARADIGM) registry. Specifically, 370 (derivation cohort) and 219 (validation cohort) patients with two repeat, clinically indicated CCTA scans, non-obstructive CAD, and absence of high-risk plaque (≥ 2 high-risk features) at baseline CCTA were included. Disease progression was defined as the new occurrence of ≥ 50% stenosis and/or high-risk plaque at follow-up CCTA.
resultsIn the derivation cohort, 104 (28%) patients experienced disease progression. The median time interval between the two CCTAs was 3.3 years (2.7-4.8). Odds ratios for disease progression derived from multivariable logistic regression were as follows: 4.59 (95% confidence interval: 1.69-12.48) for the number of plaques with spotty calcification, 3.73 (1.46-9.52) for the number of plaques with low attenuation component, 2.71 (1.62-4.50) for 25-49% stenosis severity, 1.47 (1.17-1.84) for the number of bifurcation plaques, and 1.21 (1.02-1.42) for the time between the two CCTAs. The C-statistics of the model were 0.732 (0.676-0.788) and 0.668 (0.583-0.752) in the derivation and validation cohorts, respectively.
conclusionsThe new CCTA-based risk score is a simple and practical tool that can predict mid-term CAD progression in patients with known non-obstructive CAD. CLINICAL RELEVANCE STATEMENT: The clinical implementation of this new CCTA-based risk score can help promote the management of patients with non-obstructive coronary disease in terms of timing of imaging follow-up and therapeutic strategies. KEY POINTS: • No recommendations are available on the use of repeat CCTA in patients with non-obstructive CAD. • This new CCTA score predicts mid-term CAD progression in patients with non-obstructive stenosis at baseline. • This new CCTA score can help guide the clinical management of patients with non-obstructive CAD.
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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.