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January 4, 2021International Journal of CardiologyOpen Access

Deep learning-derived CAC ≥400 on non-gated CT predicts ~119% higher MACE risk and improves reclassification.

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Why the study?

The prognostic value of automated deep learning-derived CAC scores on low-dose attenuation correction CT images during MPI was unknown.

Does automated coronary calcium scoring derived by deep learning on non-ECG gated CT images predict MACE in patients suspected of CAD?

Population

Chest-pain cohort undergoing RubidiumPET/CT without a history of coronary revascularization

Comparison

High CAC score (≥400) vs low CAC score (<400)

Design

Cohort study

Follow-up

4 years

Key result

Automated deep learning-derived high CAC scores (≥400) on non-ECG gated CT images independently predicted MACE (HR 2.19; 95% CI 1.43-3.35) and improved risk reclassification.

Authors

MDMirthe DekkerFWFarahnaz WaissiIBIngrid E.M. Bank

Discussion

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Overview

May refine MACE risk stratification beyond perfusion imaging; leaves open need for prospective trials before clinical adoption.

Study Design

Type

Cohort

Structured PICO

Does automated coronary calcium scoring derived by deep learning on non-ECG gated CT images predict MACE in patients suspected of CAD?

P
Population
Patients suspected of coronary artery disease presenting with chest pain, undergoing 82Rb-PET/CT myocardial perfusion imaging, without a history of coronary revascularization.
I
Intervention
Automated coronary artery calcium (CAC) scoring using a deep learning approach on non-ECG gated low-dose attenuation correction CT images
C
Comparator
Low automated CAC score (<400)
O
Outcome
Major adverse cardiovascular events (MACE), defined as a composite of all-cause death, late revascularization (>90 days after scanning), or nonfatal myocardial infarction at 4 years follow-upcomposite

Main Result

Effect estimate: HR 2.19 (95% CI 1.43-3.35)

p-value: p=<0.001

Automated deep learning-derived CAC scores from non-ECG gated PET/CT attenuation correction images provide independent prognostic value for MACE beyond myocardial perfusion imaging alone.

Cite This Study

Dekker et al. (2021) conducted a cohort in Suspected coronary artery disease. Automated deep learning-derived CAC score vs. Low CAC score (<400) was evaluated on Major adverse cardiovascular events (all cause death, late revascularization >90 days, or nonfatal myocardial infarction) (HR 2.19, 95% CI 1.43-3.35, p=<0.001). Automated deep learning-derived high CAC scores (≥400) on non-ECG gated CT images independently predicted MACE (HR 2.19; 95% CI 1.43-3.35) and improved risk reclassification.

synapsesocial.com/papers/6a0a57dcfdd00ab7863dcacfhttps://doi.org/10.1016/j.ijcard.2020.12.079
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