Table 2.
Association of different definitions for CAD severity and HRP characteristics with adverse events in PROMISE patients
| Variables | Events N (%) |
Unadjusted | Adjusted for ASCVD risk score (continuous variable) |
||
|---|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | ||
| Degree of stenosis by CTA with following definitions: | |||||
| 1. Traditional Definition I | |||||
| No CAD | 10/1,303 (0.8) | Base | --- | Base | --- |
| Mild CAD (1-49% stenosis) | 58/2,003 (2.9) | 3.82 (1.95–7.48) | <0.001 | 3.40 (1.73–6.70) | <0.001 |
| Moderate CAD (50-69% stenosis) | 18/294 (6.1) | 8.25 (3.81–17.86) | <0.001 | 6.91 (3.14–15.18) | <0.001 |
| Severe CAD (≥50% stenosis of LM or ≥70% in any major vessel) | 29/240 (12.1) | 17.61 (8.58–36.14) | <0.001 | 13.26 (6.28–28.00) | <0.001 |
| 2. Traditional Definition II | |||||
| Normal (No CAD) | 10/1,303 (0.8) | Base | --- | Base | --- |
| Mildly abnormal (1-69% stenosis in any major vessels or <50% LM stenosis) | 76/2,297 (3.3) | 4.38 (2.26–8.46) | <0.001 | 3.82 (1.96–7.44) | <0.001 |
| Moderately abnormal (≥70% in one major vessel) | 19/145 (13.1) | 19.21 (8.93–41.32) | <0.001 | 15.18 (6.92–33.29) | <0.001 |
| Severely abnormal (≥2 vessel disease (≥70%) or ≥50% left main stenosis or ≥70% proximal left anterior descending stenosis) | 10/95 (10.5) | 15.20 (6.33–36.53) | <0.001 | 9.62 (3.72–24.84) | <0.001 |
| 3. CAD-RADS Stenosis Categories | |||||
| No plaque/stenosis – CAD-RADS 0 | 10/1,303 (0.8) | Base | --- | Base | --- |
| 1-29% - CAD-RADS 1 | 25/1,236 (2.0) | 2.66 (1.28–5.54) | 0.009 | 2.43 (1.16–5.08) | 0.019 |
| 30-49% - CAD-RADS 2 | 33/767 (4.3) | 5.70 (2.81–11.57) | <0.001 | 5.02 (2.45–10.28) | <0.001 |
| 50-69% - CAD-RADS 3 | 18/294 (6.1) | 8.25 (3.81–17.87) | <0.001 | 7.03 (3.20–15.47) | <0.001 |
| 70-99% - CAD-RADS 4a | 19/186 (10.2) | 14.38 (6.69–30.93) | <0.001 | 11.39 (5.16–25.12) | <0.001 |
| ≥50% LM or ≥70% in 3 vessels or total occlusion - CAD-RADS 4b+5 | 10/54 (18.5) | 30.80 (12.81–74.07 | <0.001 | 21.84 (8.63–55.26) | <0.001 |
| High-risk plaque features* | |||||
| Absence of “Vulnerable Plaque” | 84/3,424 (2.5) | Base | --- | Base | --- |
| Presence of “Vulnerable Plaque” | 31/416 (7.5) | 3.08 (2.04–4.65) | <0.001 | 2.61 (1.71–3.98) | <0.001 |
CAC, coronary artery calcium; CAD, coronary artery disease; CTA, coronary computed tomography angiography; LAD, left ascending coronary artery; LM, left main coronary artery; Adverse events include all-cause death, hospitalization for unstable angina, and MI.
*
Presence of “vulnerable plaque” defined as two or more high-risk plaque features in at least one coronary plaque/segment.