Use of High-Risk Coronary Atherosclerotic Plaque Detection for Risk Stratification of Patients With Stable Chest Pain

Use of High-Risk Coronary Atherosclerotic Plaque Detection for Risk Stratification of Patients... Key PointsQuestionIs high-risk plaque, as detected by coronary computed tomographic angiography, associated with incident major adverse cardiovascular events? FindingsIn this substudy of the PROMISE trial, we evaluated the presence of high-risk plaque in 4415 patients. High-risk plaque was present in 676 patients (15%) and carried a 70% increased risk of major adverse cardiovascular events independent of cardiovascular risk factors and obstructive coronary artery disease; detection was most useful in younger patients, women, and those with nonobstructive coronary artery disease. MeaningThe findings suggest the potential significance of detecting high-risk plaques in patients with stable ischemic heart disease; however, the low absolute rates of major adverse cardiovascular events and low positive predictive value of high-risk plaque detection might limit its clinical applicability. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Cardiology American Medical Association
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Publisher
American Medical Association
Copyright
Copyright 2018 American Medical Association. All Rights Reserved.
ISSN
2380-6583
eISSN
2380-6591
D.O.I.
10.1001/jamacardio.2017.4973
Publisher site
See Article on Publisher Site

Abstract

Key PointsQuestionIs high-risk plaque, as detected by coronary computed tomographic angiography, associated with incident major adverse cardiovascular events? FindingsIn this substudy of the PROMISE trial, we evaluated the presence of high-risk plaque in 4415 patients. High-risk plaque was present in 676 patients (15%) and carried a 70% increased risk of major adverse cardiovascular events independent of cardiovascular risk factors and obstructive coronary artery disease; detection was most useful in younger patients, women, and those with nonobstructive coronary artery disease. MeaningThe findings suggest the potential significance of detecting high-risk plaques in patients with stable ischemic heart disease; however, the low absolute rates of major adverse cardiovascular events and low positive predictive value of high-risk plaque detection might limit its clinical applicability.

Journal

JAMA CardiologyAmerican Medical Association

Published: Feb 10, 2018

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