Natural History of Adapted Leaman Score Assessing Coronary Artery Disease Progression by Computed Tomography Angiography: A 7-Year Follow-Up Report.

Natural History of Adapted Leaman Score Assessing Coronary Artery Disease Progression by Computed Tomography Angiography: A 7-Year Follow-Up Report. - 2021

Available in print through MWHC library: 2002 - present

BACKGROUND: Coronary computed tomographic angiography (CCTA) provides a non-invasive assessment of the coronary artery tree. Computed Tomography - adapted Leaman Score (CT-LeSc) has been shown to be an independent predictor of cardiac events in coronary artery disease (CAD) patients with a score greater than 5 (high). CONCLUSION: In patients at high-risk for cardiac events, as determined by CT-LeSc, there was an increase in CT-LeSc, obstructive lesions, and calcified plaques over the 7-year follow-up period. Most of the new lesions were obstructive and non-calcified. This is the first report showing long term serial imaging CCTA changes in a high-risk population. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: Patients with multivessel CAD and CCTA assessments at baseline and follow-up were included. The CT-LeSc analysis was performed in a paired fashion. The patient-level scores and the differences between each phase were assessed by 2 analysts in an independent CoreLab. PURPOSE: To investigate the relationship between CT-LeSc and the progression of CAD and to provide vessel- and segment-level CAD qualification and quantification at baseline and 7-year follow-up. RESULTS: This study analyzed 248 coronary segments from 17 patients with a mean follow-up interval of 7.5 +/- 0.6 years. The mean CT-LeSc at baseline and follow-up were 14.6 +/- 4.2 and 16.9 +/- 1.5, respectively, with an absolute increase of 2.3 +/- 1.8. The mean cumulative increase of new lesions was 0.2 +/- 0.2 per year. Over time, 14.6% of the non-obstructive lesions became obstructive, and 15.0% of the non-calcified plaques became calcified. There were 29 new lesions found at follow-up, and out of these, 16 were obstructive and 19 were non-calcified.


English

1878-0938

10.1016/j.carrev.2020.07.023 [doi] S1553-8389(20)30449-8 [pii]


*Coronary Artery Disease
*Coronary Stenosis
*Plaque, Atherosclerotic
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease/dg [Diagnostic Imaging]
Follow-Up Studies
Humans
Predictive Value of Tests
Risk Assessment
Tomography, X-Ray Computed


MedStar Heart & Vascular Institute
MedStar Washington Hospital Center


Journal Article

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