从冠状动脉计算机断层血管造影中量化斑块预测心血管事件：系统回顾和荟萃分析。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography Pub Date : 2025-07-01 DOI:10.1016/j.jcct.2025.05.003

Jack S. Bell , Jonathan Weir-McCall , Edward Nicol , Gregory Y.H. Lip , Bjarne L. Nørgaard , Timothy A. Fairbairn

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引用次数: 0

摘要

背景：冠状动脉计算机断层血管造影（CCTA）量化斑块体积，可以提高对未来主要不良心血管事件（MACE）的风险预测，高于当前的护理标准。本系统综述和荟萃分析探讨了稳定型冠状动脉疾病（CAD）患者ccta衍生斑块体积与未来MACE之间的关系。方法：采用PubMed、Web of Science和Cochrane Library数据库进行系统的文献检索。504份出版物被筛选，确定38项研究纳入系统评价。15项研究符合meta分析的条件。对最常见的斑块体积变量进行了单独的荟萃分析。结果：38项纳入的研究中有35项显示量化斑块体积与MACE之间存在关联。低衰减斑块（LAP）体积和总斑块体积（TPV）最常与MACE独立相关。meta分析显示，MACE与TPV（合并HR 3.93, 95% CI 2.10-7.34, p < 0.0001）、LAP体积（合并HR 2.81, 95% CI 2.01-3.93, p < 0.0001）、钙化斑块体积（合并HR 2.21, 95% 1.5-3.24, p < 0.0001）、非钙化斑块体积（合并HR 2.55, 95% CI 1.30-4.98, p = 0.006）、LAP负担（合并HR 3.22, 95% CI 2.12-4.87, p < 0.0001）、钙化斑块负担（合并HR 2.25, 95% 1.56-3.24, p < 0.0001）、p < 0.0001)和非钙化斑块负担（合并HR 3.42, 95% CI 1.49-7.81, p = 0.004）。在排除了一项具有相当异质性的小型研究后，总斑块负担与MACE显著相关（合并HR 3.81, 95% CI 2.45-5.94, p < 0.0001）。结论：量化斑块体积与接受CCTA治疗稳定CAD患者的MACE相关。未来的工作需要在不同的人群中使用标准化的方法来确定斑块量化在现实世界中的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Plaque quantification from coronary computed tomography angiography in predicting cardiovascular events: A systematic review and meta-analysis

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Plaque quantification from coronary computed tomography angiography in predicting cardiovascular events: A systematic review and meta-analysis

Background

Plaque volumes quantified from coronary computed tomography angiography (CCTA) may offer improved risk prediction for future major adverse cardiovascular events (MACE) above current standards of care. This systematic review and meta-analysis examines the association between CCTA-derived plaque volumes and future MACE in stable coronary artery disease (CAD).

Methods

A systematic literature search was undertaken using PubMed, Web of Science and Cochrane Library databases. 504 publications were screened, identifying 38 studies for inclusion in the systematic review. 15 studies were eligible for meta-analysis. Separate meta-analyses were conducted for the most frequently investigated plaque volume variables.

Results

35 out of 38 included studies showed an association between quantified plaque volumes and MACE. Low attenuation plaque (LAP) volume and total plaque volume (TPV) were most frequently independently associated with MACE. On meta-analysis, there was a significant association between MACE and TPV (pooled HR 3.93, 95 % CI 2.10–7.34, p < 0.0001), LAP volume (pooled HR 2.81, 95 % CI 2.01–3.93, p < 0.0001), calcified plaque volume (pooled HR 2.21, 95 % 1.5–3.24, p < 0.0001), non-calcified plaque volume (pooled HR 2.55, 95 % CI 1.30–4.98, p = 0.006), LAP burden (pooled HR 3.22, 95 % CI 2.12–4.87, p < 0.0001), calcified plaque burden (pooled HR 2.25, 95 % 1.56–3.24, p < 0.0001) and non-calcified plaque burden (pooled HR 3.42, 95 % CI 1.49–7.81, p = 0.004). Total plaque burden was significantly associated with MACE after exclusion of a small study driving considerable heterogeneity (pooled HR 3.81, 95 % CI 2.45–5.94, p < 0.0001).

Conclusion

Quantified plaque volumes are associated with MACE in patients undergoing CCTA for stable CAD. Future work is required in diverse populations with standardised methods to determine the clinical utility of plaque quantification in real world practice.

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来源期刊

Journal of Cardiovascular Computed Tomography CARDIAC & CARDIOVASCULAR SYSTEMS-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.50

自引率

14.80%

发文量

212

审稿时长

40 days

期刊介绍： The Journal of Cardiovascular Computed Tomography is a unique peer-review journal that integrates the entire international cardiovascular CT community including cardiologist and radiologists, from basic to clinical academic researchers, to private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our cardiovascular imaging community across the world. The goal of the journal is to advance the field of cardiovascular CT as the leading cardiovascular CT journal, attracting seminal work in the field with rapid and timely dissemination in electronic and print media.