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Prognostic value of coronary computed tomography angiography in stroke patients

Authors
 Jin Hur  ;  Kye Ho Lee  ;  Sae Rom Hong  ;  Young Joo Suh  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Hye Sun Lee  ;  Hyuk-Jae Chang  ;  Byoung Wook Choi 
Citation
 Atherosclerosis, Vol.238(2) : 271-277, 2015 
Journal Title
 Atherosclerosis 
ISSN
 0021-9150 
Issue Date
2015
Abstract
OBJECTIVE: The predictive value of coronary computed tomography angiography (CCTA) in stroke patients has not yet been established. We investigated the prognostic value of coronary artery disease (CAD) detection by CCTA, and determined the incremental risk stratification benefit of CCTA findings as compared to coronary artery calcium scores (CACS) in ischemic stroke patients without chest pain. METHODS: Among 914 consecutive ischemic stroke patients, 317 (68.5% were male with a mean age of 64 years) who had at least one clinical risk factor for CAD without chest pain were prospectively enrolled to undergo CCTA. CT images were assessed for CAC, presence of CAD and extent of CAD. The primary endpoint was major adverse cardiac events (MACEs) defined as cardiac death, non-fatal myocardial infarction, unstable angina requiring hospitalization, or revascularization after 90 days from index CCTA. RESULTS: The prevalence of CAC ≥1 was 73.1% (232/317) and the average CACS was 346.6 ± 693.5 (Agatston unit). During the median follow-up period of 409 days, there were a total of 26 MACEs. Both CACS [CAC (101-400, and >400)] and CCTA findings [presence of obstructive CAD, 1-vessel disease (VD), 2-VD, and 3-VD] independently stratified risk of future MACEs (all p < 0.05). The time-dependent receiver operating characteristic curve analysis revealed that CAD findings (presence of obstructive CAD and number of involved vessels) based on CCTA improved risk stratification beyond clinical risk factors and CACS (iAUC: 0.863 vs 0.752, p < 0.05). CONCLUSION: In ischemic stroke patients without chest pain, CCTA findings of CAD provide additional risk-discrimination over CACS.
Full Text
http://www.sciencedirect.com/science/article/pii/S0021915014015573
DOI
10.1016/j.atherosclerosis.2014.10.102
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
이계호(Lee, Kye Ho) ORCID logo https://orcid.org/0000-0001-5568-1833
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍새롬(Hong, Sae Rom)
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139370
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