CT Flashcards
(27 cards)
Quantifies CAC as a function of CAC surface area and density.
Agatston score
In some studies a CAC score of more than 300 or greater has been used as an alrernative threahold to described severely elevated CAC level
MACE rate over 4 years for CAC score of Zero
0.5%
MACE rate for CAC score > 400
10%
Study which demostrates the prognostic value of CAC across many cohorts worldwide
MESA or multi-ethnic study of atherosclerosis
According to MESA study, higher CAC were noted in the ff
Caucasians and Hispanics, male sex and advancing age
A population based cohort study that showed upper quartile CAC had an event rate 11.1 times that of lowest quartile in men and 3.2 times in women
Heinz-Nixdorf Recall study
The ff are true of CAC except
> atherosclerotic burden
independent predictor Cerebrovascular Risk
associated with future adverse clinical events, AF, cancer stroke and CHF
None of the above
RCT on atorvastatin + vit c + vit E compared to placebo showed no difference in the composite CV endpoints
St. Francis Heart Study
This study demonstrated the highest diagnostic accuracy with Sn of 91% and Sp of 92% comparing with PET, Stress echo and CMR
EVINCI study or Evaluation of Integrated Cardiac Imaging in Ischemic Heart Disease
The largest study evaluating the prognostic value of CAD findings on CCTA (2.6x increased risk of death for stenosis > 70%, increasing risk of mortality with greater # of coronary distribution, women > men greater risk of mortality, low all cause-death in thr absence of CAD by ccta)
CONFIRM study or Coronary CT Angiography Evaluation of Clinical Outcomes: an International Multicenter Registry)
Hounsfield unit cutoff point for calcified plaque
130 HU
Hounsfield unit cutoff point for lipoid plaques
< 70 HU
Hounsfield unit cutoff point for fibrous plaque
70-130 HU
Hounsfield unit cutoff point for vulnerable plaque
< 30 HU
Defined as distinct calcifications < 3mm in length circumscribing a 90 degree or less arc in cross section
Spotty calcifications
T or F. A normal CCTA appears to confer at least a 5-year warranty period
True
Fractional Flow Reserve value which demonstrates no ischemia
> 0.80
This study included 368 patients with intial negative myocardial necrosis biomarkers and a nondynamic ECG underwent CCTA for diagnosis and exclusion of ACS
ROMICAT or Rule out Myocardial Infarction Using Computed Assisted Tomography
This trial aimed to determine the prognostic utility of CCTA compared to standard of care in 299 patients presenting with acute chest pain and normal ECG and blood biomarkers.
CATCH trial or Cardiac CT in the Treatment of Acute Chest Pain Trial
This RCT evaluated the use of a CCTA based strategy vs the standard of catr at 7 sites where Hs Trop were for early diagnosis of ACS.
BEACON or Better Evaluation of Acute Chest Pain with Computed Tomography Angiography
CCTA vs MPI study ~ no difference between groups, in MACE, lower radiation for CCTA and higher px satisfaction for CCTA
PROSPECT trial
This RCT included 10,003 patients who underwent either CCTA or “functional testing”, which included not only SPECT mPI but also stress echo and stress ecg testing without imaging
PROMISE or Prospective Muticenter Imaging Study for Evaluation of Chest Pain
This trial examined an endpoint of diagnostic certainty of angina causef by CAD at 6-week endpoint
SCOT-HEART trial
This RCT examined the safety and efficacy of tiered CT approach where the less costly CAC scan was performed as the initial test, followed by CCTA only uf CAC score was between 1 and 400.
CRESCENT
