Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease
Aims: The purpose of this study was to compare coronary computed tomography angiography (CCTA) and guideline-recommended clinical risk assessment for the value in statin allocation in outpatients with suspected coronary artery disease (CAD). Methods: For the 7860 eligible outpatients with suspected...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667725000704 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850186698194944000 |
|---|---|
| author | Jianan Zheng Zhihui Hou Yang Gao Weihua Yin Yanan Ma Yunqiang An Yang Wang Lei Song Bin Lu |
| author_facet | Jianan Zheng Zhihui Hou Yang Gao Weihua Yin Yanan Ma Yunqiang An Yang Wang Lei Song Bin Lu |
| author_sort | Jianan Zheng |
| collection | DOAJ |
| description | Aims: The purpose of this study was to compare coronary computed tomography angiography (CCTA) and guideline-recommended clinical risk assessment for the value in statin allocation in outpatients with suspected coronary artery disease (CAD). Methods: For the 7860 eligible outpatients with suspected CAD who underwent CCTA, we evaluate hard atherosclerotic cardiovascular disease (ASCVD) and major adverse cardiac and cerebrovascular event (MACCE) stratified by guideline-recommended clinical risk assessment, and CCTA. For intermediate risk patients, we also compared the predictive value of CCTA and CAC. Results: Over a median follow-up period of 3.6 years, a total of 83 (1.1 %) hard ASCVD and 170 (2.2 %) MACCE occurred. The event rate increased with both the intensity of statin recommendation (e.g., hard ASCVD: 1.5 per 1000 person-years [PY] for statin not recommended, 4.1 per 1000 PY for moderate-intensity statin, and 8.9 per 1000 PY for high-intensity statin) and the severity of coronary stenosis (e.g., hard ASCVD: 0.7 per 1000 PY for no plaque, 5.1 per 1000 PY for non-obstructive CAD, and 11.2 per 1000 PY for obstructive CAD). When stratified by CCTA, higher intensity statin recommendation was not a statistically significant independent risk factor, both for hard ASCVD and MACCE. For the predictive value of hard ASCVD in intermediate risk patients, there was no statistically significant difference between CCTA and CAC (the area under the receiver operating characteristic curve: 0.692 versus 0.702; P = 0.78). Conclusions: CCTA played a more important role in statin allocation compared to guideline-recommended clinical risk assessment in outpatients who underwent CCTA. |
| format | Article |
| id | doaj-art-a08ca88280684bdeaaa92f98761a58aa |
| institution | OA Journals |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-a08ca88280684bdeaaa92f98761a58aa2025-08-20T02:16:18ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-06-012210099510.1016/j.ajpc.2025.100995Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery diseaseJianan Zheng0Zhihui Hou1Yang Gao2Weihua Yin3Yanan Ma4Yunqiang An5Yang Wang6Lei Song7Bin Lu8Department of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaMedical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing, ChinaDepartment of Cardiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Radiology, Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Corresponding author at: Fuwai Hospital, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing 100037, China.Aims: The purpose of this study was to compare coronary computed tomography angiography (CCTA) and guideline-recommended clinical risk assessment for the value in statin allocation in outpatients with suspected coronary artery disease (CAD). Methods: For the 7860 eligible outpatients with suspected CAD who underwent CCTA, we evaluate hard atherosclerotic cardiovascular disease (ASCVD) and major adverse cardiac and cerebrovascular event (MACCE) stratified by guideline-recommended clinical risk assessment, and CCTA. For intermediate risk patients, we also compared the predictive value of CCTA and CAC. Results: Over a median follow-up period of 3.6 years, a total of 83 (1.1 %) hard ASCVD and 170 (2.2 %) MACCE occurred. The event rate increased with both the intensity of statin recommendation (e.g., hard ASCVD: 1.5 per 1000 person-years [PY] for statin not recommended, 4.1 per 1000 PY for moderate-intensity statin, and 8.9 per 1000 PY for high-intensity statin) and the severity of coronary stenosis (e.g., hard ASCVD: 0.7 per 1000 PY for no plaque, 5.1 per 1000 PY for non-obstructive CAD, and 11.2 per 1000 PY for obstructive CAD). When stratified by CCTA, higher intensity statin recommendation was not a statistically significant independent risk factor, both for hard ASCVD and MACCE. For the predictive value of hard ASCVD in intermediate risk patients, there was no statistically significant difference between CCTA and CAC (the area under the receiver operating characteristic curve: 0.692 versus 0.702; P = 0.78). Conclusions: CCTA played a more important role in statin allocation compared to guideline-recommended clinical risk assessment in outpatients who underwent CCTA.http://www.sciencedirect.com/science/article/pii/S2666667725000704AtherosclerosisCoronary artery diseaseCoronary computed tomography angiographyRisk stratificationClinical risk scorePrognosis |
| spellingShingle | Jianan Zheng Zhihui Hou Yang Gao Weihua Yin Yanan Ma Yunqiang An Yang Wang Lei Song Bin Lu Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease American Journal of Preventive Cardiology Atherosclerosis Coronary artery disease Coronary computed tomography angiography Risk stratification Clinical risk score Prognosis |
| title | Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| title_full | Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| title_fullStr | Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| title_full_unstemmed | Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| title_short | Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| title_sort | coronary computed tomography angiography versus guideline recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease |
| topic | Atherosclerosis Coronary artery disease Coronary computed tomography angiography Risk stratification Clinical risk score Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S2666667725000704 |
| work_keys_str_mv | AT jiananzheng coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT zhihuihou coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT yanggao coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT weihuayin coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT yananma coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT yunqiangan coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT yangwang coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT leisong coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease AT binlu coronarycomputedtomographyangiographyversusguidelinerecommendedclinicalriskassessmentforstatinallocationinoutpatientswithsuspectedcoronaryarterydisease |