@article{21972,
  author = {Chen L. and Kritharides L. and Hillis G. and Ayoub C. and Yam Y. and Arasaratnam P. and Chow B. and Chow Clara},
  title = {The Prognostic Value of Percentage Total Plaque Score Adjusted to Age: A Potential Marker of Coronary Vascular Age},
  abstract = {<p>
BACKGROUND: Total plaque score (TPS) on coronary computed tomography angiography (CCTA) has been validated as a surrogate measure of coronary artery disease (CAD) burden and is prognostic. We propose a novel measure, percentage TPS adjusted to age (%TPS/age), that may reflect vascular age and potentially more rapidly progressive atherosclerosis and evaluate its potential prognostic value. METHODS: %TPS/age was calculated for consecutive patients prospectively enrolled into our institutional CCTA registry and evaluated for primary composite outcome of cardiac death, nonfatal myocardial infarction, and late revascularization. RESULTS: Of 1896 patients identified (mean age 57.7 +/- 11.4 years, 50.1% male, median follow-up 18.6 months [interquartile range: 15.3, 32.4]), 552 (29%) had %TPS/age = 0 (no atherosclerosis), with 1 (0.2%) primary outcome observed (annual event rate [AER] = 0.1%). Two events (0.4%, AER = 0.3%) were observed in %TPS/age &lt; 0.314 category, 22 (5.0%, AER = 2.2%) in %TPS/age 0.314 to 0.699 category, and 54 (12.0%, AER = 5.7%) in %TPS/age &gt;/= 0.700 category. After adjusting for clinical predictors and obstructive CAD, higher %TPS/age category was associated with hazard ratio 1.95 (1.31-2.88, P &lt; .001) for primary outcome on multivariable analysis, Harrell-C-Statistic 0.87 (confidence interval 95%: 0.84-0.90), and net reclassification improvement of 0.71 (P &lt; .001). CONCLUSION: %TPS/Age has incremental prognostic value to traditional risk factors and CCTA measures of CAD and improves evaluation of burden of coronary atherosclerosis and clinical risk.
</p>
},
  year = {2016},
  journal = {Angiology},
  edition = {2016/02/24},
  isbn = {1940-1574 (Electronic)<br/>0003-3197 (Linking)},
  note = {Ayoub, Chadi<br/>Yam, Yeung<br/>Chen, Li<br/>Arasaratnam, Punitha<br/>Chow, Clara K<br/>Hillis, Graham S<br/>Kritharides, Leonard<br/>Chow, Benjamin J W<br/>Angiology. 2016 Feb 22. pii: 0003319716633354.},
  language = {Eng},
}