Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry

BackgroundWhether coronary plaque characteristics assessed in computed tomography angiography (CCTA) association with the artery calcium score (CACS) have predictive value for events is unclear. We aimed to examine of CACS and occurrence events.MethodsAmong 2802 patients who were analyzed PREDICT registry, 2083 suspected disease (CAD) studied using post hoc analysis. High-risk plaques defined as having ≥2 adverse characteristics, such low tomographic attenuation, positive remodeling, spotty calcification, napkin-ring sign. An adjudicative composite (cardiac death, nonfatal acute syndrome, revascularization ≥3 months after indexed CCTA) analyzed.ResultsSeventy-three (3.5%) had 313 (15.0%) high-risk plaques. Multivariate Cox proportional hazard analysis showed that remained an independent predictor (adjusted ratio [HR] 1.95, 95% confidence interval [CI] 1.13–3.34, P ​= ​0.0154), well log-transformed HR 1.24, CI 1.11–1.39, ​0.0002) presence obstructive stenosis 5.63, 3.22–10.12, 0.0001). In subgroup analyses, independently only class (<100).ConclusionThis study shows assessment features by imaging predicts CAD a CACS. Our findings suggest clinical appears marginal.