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1. Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial

Author

Mancone, Massimo, Mézquita, Aldo J. Vázquez, Birtolo, Lucia Ilaria, Maurovich-Horvat, Pal, Kofoed, Klaus F., Benedek, Theodora, Donnelly, Patrick, Rodriguez-Palomares, Jose, Erglis, Andrejs, Štěchovský, Cyril, Šakalytė, Gintare, Ađić, Nada Čemerlić, Gutberlet, Matthias, Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhanni, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Hansen, Kristian Schultz, Müller-Nordhorn, Jaqueline, Merkely, Bela, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Suchánek, Vojtěch, Jankauskas, Antanas, Ađić, Filip, Woinke, Michael, Keane, Stephen, Lecumberri, Ignacio, Thwaite, Erica, Kruk, Mariusz, Jovanovic, Vladimir, Kuśmierz, Donata, Feuchtner, Gudren, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Palmisano, Vitanio, Fisher, Michael, Drobni, Zsófia D., Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, del Blanco, Bruno Garcia, Rubio, Ainhoa, Boussoussou, Melinda, Hove, Jens D., Rodean, Ioana, Regan, Susan, Calabria, Hug Cuéllar, Becker, Dávid, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Douglas, Pamela S., Estrella, Melanie, Bosserdt, Maria, Martus, Peter, Serna-Higuita, Lina M., Dodd, Jonathan D., and Dewey, Marc

Published
2024
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4. Ultra-high resolution coronary CT angiography on photon-counting detector CT: bi-centre study on the impact of quantum iterative reconstruction on image quality and accuracy of stenosis measurements

Author

Vecsey-Nagy, Milan, Varga-Szemes, Akos, Schoepf, U. Joseph, Tremamunno, Giuseppe, Fink, Nicola, Zsarnoczay, Emese, Szilveszter, Bálint, Graafen, Dirk, Halfmann, Moritz C, Vattay, Borbála, Boussoussou, Melinda, O’Doherty, Jim, Suranyi, Pal Spruill, Maurovich-Horvat, Pál, and Emrich, Tilman

Published
2024
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6. Photon-counting detector CT reduces the rate of referrals to invasive coronary angiography as compared to CT with whole heart coverage energy-integrating detector

Author

Simon, Judit, Hrenkó, Áron, Kerkovits, Nóra Melinda, Nagy, Kristóf, Vértes, Miklós, Balogh, Hanna, Nagy, Norbert, Munkácsi, Tamás, Emrich, Tilman, Varga-Szemes, Akos, Boussoussou, Melinda, Vattay, Borbála, Vecsey-Nagy, Milán, Kolossváry, Márton, Szilveszter, Bálint, Merkely, Béla, and Maurovich-Horvat, Pál

Published
2024
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9. Coronary CT-based FFR in patients with acute myocardial infarction might predict follow-up invasive FFR: The XPECT-MI study

Author

Boussoussou, Melinda, Édes, István F., Nowotta, Fanni, Vattay, Borbála, Vecsey-Nagy, Milán, Drobni, Zsófia, Simon, Judit, Kolossváry, Márton, Németh, Balázs, Jermendy, Ádám L., Becker, Dávid, Leipsic, Jonathon, Rogers, Campbell, Collinsworth, Amy, Maurovich-Horvat, Pál, Merkely, Béla, and Szilveszter, Bálint

Published
2023
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14. Coronary Artery Calcium Score Predicts Major Adverse Cardiovascular Events in Stable Chest Pain

Author

Biavati, Federico, Saba, Luca, Boussoussou, Melinda, Kofoed, Klaus F., Benedek, Theodora, Donnelly, Patrick, Rodríguez-Palomares, José, Erglis, Andrejs, Štěchovský, Cyril, Šakalytė, Gintarė, Ađić, Nada Čemerlić, Gutberlet, Matthias, Dodd, Jonathan D., Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Hansen, Kristian Schultz, Müller-Nordhorn, Jacqueline, Maurovich-Horvat, Pál, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Suchánek, Vojtěch, Jankauskas, Antanas, Ađić, Filip, Woinke, Michael, Cadogan, Diarmaid, Lecumberri, Iñigo, Thwaite, Erica, Kruk, Mariusz, Neskovic, Aleksandar N., Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Cau, Riccardo, Fisher, Michael, Merkely, Bela, Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, del Blanco, Bruno García, Rubio, Ainhoa, Szilveszter, Bálint, Hove, Jens D., Rodean, Ioana, Regan, Susan, Calabria, Hug Cuéllar, Édes, István Ferenc, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Budoff, Matthew J., Estrella, Melanie, Martus, Peter, Bosserdt, Maria, Dewey, Marc, Biavati, Federico, Saba, Luca, Boussoussou, Melinda, Kofoed, Klaus F., Benedek, Theodora, Donnelly, Patrick, Rodríguez-Palomares, José, Erglis, Andrejs, Štěchovský, Cyril, Šakalytė, Gintarė, Ađić, Nada Čemerlić, Gutberlet, Matthias, Dodd, Jonathan D., Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Hansen, Kristian Schultz, Müller-Nordhorn, Jacqueline, Maurovich-Horvat, Pál, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Suchánek, Vojtěch, Jankauskas, Antanas, Ađić, Filip, Woinke, Michael, Cadogan, Diarmaid, Lecumberri, Iñigo, Thwaite, Erica, Kruk, Mariusz, Neskovic, Aleksandar N., Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Cau, Riccardo, Fisher, Michael, Merkely, Bela, Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, del Blanco, Bruno García, Rubio, Ainhoa, Szilveszter, Bálint, Hove, Jens D., Rodean, Ioana, Regan, Susan, Calabria, Hug Cuéllar, Édes, István Ferenc, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Budoff, Matthew J., Estrella, Melanie, Martus, Peter, Bosserdt, Maria, and Dewey, Marc

Abstract

Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA. Participants were randomly assigned to undergo either ICA or coronary CT. CAC scores from noncontrast CT scans were categorized into low, intermediate, and high groups based on scores of 0, 1–399, and 400 or higher, respectively. The end point of the study was the occurrence of MACE (myocardial infarction, stroke, and cardiovascular death) over a median 3.5-year follow-up, analyzed using Cox proportional hazard regression tests. Results The study involved 1749 participants (mean age, 60 years ± 10 [SD]; 992 female). The prevalence of obstructive coronary artery disease (CAD) at CT angiography rose from 4.1% (95% CI: 2.8, 5.8) in the CAC score 0 group to 76.1% (95% CI: 70.3, 81.2) in the CAC score 400 or higher group. Revascularization rates increased from 1.7% to 46.2% across the same groups (P < .001). The CAC score 0 group had a lower MACE risk (0.5%; HR, 0.08 [95% CI: 0.02, 0.30]; P < .001), as did the 1–399 CAC score group (1.9%; HR, 0.27 [95% CI: 0.13, 0.59]; P = .001), compared with the 400 or higher CAC score group (6.8%). No significant difference in MACE between sexes was observed (P = .68). Conclusion In participants with stable chest pain initially referred for ICA, a CAC score of 0 showed very low risk, Background: Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose: To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods: This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA. Participants were randomly assigned to undergo either ICA or coronary CT. CAC scores from noncontrast CT scans were categorized into low, intermediate, and high groups based on scores of 0, 1-399, and 400 or higher, respectively. The end point of the study was the occurrence of MACE (myocardial infarction, stroke, and cardiovascular death) over a median 3.5-year follow-up, analyzed using Cox proportional hazard regression tests. Results: The study involved 1749 participants (mean age, 60 years ± 10 [SD]; 992 female). The prevalence of obstructive coronary artery disease (CAD) at CT angiography rose from 4.1% (95% CI: 2.8, 5.8) in the CAC score 0 group to 76.1% (95% CI: 70.3, 81.2) in the CAC score 400 or higher group. Revascularization rates increased from 1.7% to 46.2% across the same groups (P < .001). The CAC score 0 group had a lower MACE risk (0.5%; HR, 0.08 [95% CI: 0.02, 0.30]; P < .001), as did the 1-399 CAC score group (1.9%; HR, 0.27 [95% CI: 0.13, 0.59]; P = .001), compared with the 400 or higher CAC score group (6.8%). No significant difference in MACE between sexes was observed (P = .68). Conclusion: In participants with stable chest pain initially referred for ICA, a CAC score of 0 showed very low risk of MACE, and higher CAC scores showed increasin

Published
2024

15. Erratum. Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease. Diabetes Care 2023;46:2015–2023

Author

Benedek, Theodora, primary, Wieske, Viktoria, additional, Szilveszter, Bálint, additional, Kofoed, Klaus F., additional, Donnelly, Patrick, additional, Rodriguez-Palomares, José, additional, Erglis, Andrejs, additional, Veselka, Josef, additional, Šakalytė, Gintarė, additional, Ađić, Nada Čemerlić, additional, Gutberlet, Matthias, additional, Diez, Ignacio, additional, Davis, Gershan, additional, Zimmermann, Elke, additional, Kępka, Cezary, additional, Vidakovic, Radosav, additional, Francone, Marco, additional, Ilnicka-Suckiel, Małgorzata, additional, Plank, Fabian, additional, Knuuti, Juhani, additional, Faria, Rita, additional, Schröder, Stephen, additional, Berry, Colin, additional, Saba, Luca, additional, Ruzsics, Balazs, additional, Rieckmann, Nina, additional, Kubiak, Christine, additional, Hansen, Kristian Schultz, additional, Müller-Nordhorn, Jacqueline, additional, Merkely, Bela, additional, Sigvardsen, Per E., additional, Benedek, Imre, additional, Orr, Clare, additional, Valente, Filipa Xavier, additional, Zvaigzne, Ligita, additional, Horváth, Martin, additional, Jankauskas, Antanas, additional, Ađić, Filip, additional, Woinke, Michael, additional, Mulvihill, Niall, additional, Lecumberri, Iñigo, additional, Thwaite, Erica, additional, Laule, Michael, additional, Kruk, Mariusz, additional, Stefanovic, Milica, additional, Mancone, Massimo, additional, Kuśmierz, Donata, additional, Feuchtner, Gudrun, additional, Pietilä, Mikko, additional, Ribeiro, Vasco Gama, additional, Drosch, Tanja, additional, Delles, Christian, additional, Melis, Marco, additional, Fisher, Michael, additional, Boussoussou, Melinda, additional, Kragelund, Charlotte, additional, Aurelian, Rosca, additional, Kelly, Stephanie, additional, Blanco, Bruno Garcia del, additional, Rubio, Ainhoa, additional, Károlyi, Mihály, additional, Hove, Jens D., additional, Rodean, Ioana, additional, Regan, Susan, additional, Calabria, Hug Cuéllar, additional, Gellér, László, additional, Larsen, Linnea, additional, Hodas, Roxana, additional, Napp, Adriane E., additional, Haase, Robert, additional, Feger, Sarah, additional, Mohamed, Mahmoud, additional, Serna-Higuita, Lina M., additional, Neumann, Konrad, additional, Dreger, Henryk, additional, Rief, Matthias, additional, Danesh, John, additional, Estrella, Melanie, additional, Bosserdt, Maria, additional, Martus, Peter, additional, Dodd, Jonathan D., additional, and Dewey, Marc, additional

Published
2024
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16. Photon-counting detector CT reduces the rate of referrals to invasive coronary angiography as compared to CT with whole heart coverage energy-integrating detector

Author

Simon, Judit, primary, Hrenkó, Áron, additional, Kerkovits, Nóra Melinda, additional, Nagy, Kristóf, additional, Vértes, Miklós, additional, Balogh, Hanna, additional, Nagy, Norbert, additional, Munkácsi, Tamás, additional, Emrich, Tilman, additional, Varga-Szemes, Akos, additional, Boussoussou, Melinda, additional, Vattay, Borbála, additional, Vecsey-Nagy, Milán, additional, Kolossváry, Márton, additional, Szilveszter, Bálint, additional, Merkely, Béla, additional, and Maurovich-Horvat, Pál, additional

Published
2023
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18. Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial

Author

Mancone, Massimo, primary, Mézquita, Aldo J. Vázquez, additional, Birtolo, Lucia Ilaria, additional, Maurovich-Horvat, Pal, additional, Kofoed, Klaus F., additional, Benedek, Theodora, additional, Donnelly, Patrick, additional, Rodriguez-Palomares, Jose, additional, Erglis, Andrejs, additional, Štěchovský, Cyril, additional, Šakalytė, Gintare, additional, Ađić, Nada Čemerlić, additional, Gutberlet, Matthias, additional, Diez, Ignacio, additional, Davis, Gershan, additional, Zimmermann, Elke, additional, Kępka, Cezary, additional, Vidakovic, Radosav, additional, Francone, Marco, additional, Ilnicka-Suckiel, Małgorzata, additional, Plank, Fabian, additional, Knuuti, Juhanni, additional, Faria, Rita, additional, Schröder, Stephen, additional, Berry, Colin, additional, Saba, Luca, additional, Ruzsics, Balazs, additional, Rieckmann, Nina, additional, Kubiak, Christine, additional, Hansen, Kristian Schultz, additional, Müller-Nordhorn, Jaqueline, additional, Merkely, Bela, additional, Sigvardsen, Per E., additional, Benedek, Imre, additional, Orr, Clare, additional, Valente, Filipa Xavier, additional, Zvaigzne, Ligita, additional, Suchánek, Vojtěch, additional, Jankauskas, Antanas, additional, Ađić, Filip, additional, Woinke, Michael, additional, Keane, Stephen, additional, Lecumberri, Ignacio, additional, Thwaite, Erica, additional, Kruk, Mariusz, additional, Jovanovic, Vladimir, additional, Kuśmierz, Donata, additional, Feuchtner, Gudren, additional, Pietilä, Mikko, additional, Ribeiro, Vasco Gama, additional, Drosch, Tanja, additional, Delles, Christian, additional, Palmisano, Vitanio, additional, Fisher, Michael, additional, Drobni, Zsófia D., additional, Kragelund, Charlotte, additional, Aurelian, Rosca, additional, Kelly, Stephanie, additional, del Blanco, Bruno Garcia, additional, Rubio, Ainhoa, additional, Boussoussou, Melinda, additional, Hove, Jens D., additional, Rodean, Ioana, additional, Regan, Susan, additional, Calabria, Hug Cuéllar, additional, Becker, Dávid, additional, Larsen, Linnea, additional, Hodas, Roxana, additional, Napp, Adriane E., additional, Haase, Robert, additional, Feger, Sarah, additional, Mohamed, Mahmoud, additional, Neumann, Konrad, additional, Dreger, Henryk, additional, Rief, Matthias, additional, Wieske, Viktoria, additional, Douglas, Pamela S., additional, Estrella, Melanie, additional, Bosserdt, Maria, additional, Martus, Peter, additional, Serna-Higuita, Lina M., additional, Dodd, Jonathan D., additional, and Dewey, Marc, additional

Published
2023
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19. Dynamic Perfusion Computed Tomography for the Assessment of Concomitant Coronary Artery Disease in Patients with a History of Percutaneous Transluminal Angioplasty for Chronic Limb-Threatening Ischemia—A Pilot Study

Author

Nagy, Ferenc T., primary, Olajos, Dorottya, additional, Vattay, Borbála, additional, Borzsák, Sarolta, additional, Boussoussou, Melinda, additional, Deák, Mónika, additional, Vecsey-Nagy, Milán, additional, Sipos, Barbara, additional, Jermendy, Ádám L., additional, Tóth, Gábor G., additional, Nemes, Balázs, additional, Merkely, Béla, additional, Szili-Török, Tamás, additional, Ruzsa, Zoltán, additional, and Szilveszter, Bálint, additional

Published
2023
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20. CT versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease

Author

Benedek, Theodora, primary, Wieske, Viktoria, primary, Szilveszter, Bálint, primary, Kofoed, Klaus F, primary, Donnelly, Patrick, primary, Rodriguez-Palomares, José, primary, Erglis, Andrejs, primary, Veselka, Josef, primary, Šakalytė, Gintarė, primary, Čemerlić Ađić, Nada, primary, Gutberlet, Matthias, primary, Diez, Ignacio, primary, Davis, Gershan, primary, Zimmermann, Elke, primary, Kępka, Cezary, primary, Vidakovic, Radosav, primary, Francone, Marco, primary, Ilnicka-Suckiel,, Małgorzata, primary, Plank, Fabian, primary, Knuuti, Juhani, primary, Faria, Rita, primary, Schröder, Stephen, primary, Berry, Colin, primary, Saba, Luca, primary, Ruzsics, Balazs, primary, Rieckmann, Nina, primary, Kubiak, Christine, primary, Hansen, Kristian Schultz, primary, Müller-Nordhorn, Jacqueline, primary, Merkely, Bela, primary, Sigvardsen, Per E, primary, Benedek, Imre, primary, Orr, Clare, primary, Xavier Valente, Filipa, primary, Zvaigzne, Ligita, primary, Horváth, Martin, primary, Jankauskas, Antanas, primary, Ađić, Filip, primary, Woinke, Michael, primary, Mulvihill, Niall, primary, Lecumberri, Iñigo, primary, Thwaite, Erica, primary, Laule, Michael, primary, Kruk, Mariusz, primary, Stefanovic, Milica, primary, Mancone, Massimo, primary, Kuśmierz, Donata, primary, Feuchtner, Gudrun, primary, Pietilä, Mikko, primary, Ribeiro, Vasco Gama, primary, Drosch, Tanja, primary, Delles, Christian, primary, Melis, Marco, primary, Fisher, Michael, primary, Boussoussou, Melinda, primary, Kragelund, Charlotte, primary, Aurelian, Rosca, primary, Kelly, Stephanie, primary, del Blanco, Bruno Garcia, primary, Rubio, Ainhoa, primary, Károlyi, Mihály, primary, Hove, Jens D., primary, Rodean, Ioana, primary, Regan, Susan, primary, Cuéllar-Calabria, Hug, primary, Gellér, László, primary, Larsen, Solveig Linnea Veen, primary, Hodas, Roxana, primary, E. Napp, Adriane, primary, Haase, Robert, primary, Feger, Sarah, primary, Mohamed, Mahmoud, primary, M. Serna-Higuita, Lina, primary, Neumann, Konrad, primary, Dreger, Henryk, primary, Rief, Matthias, primary, Danesh, John, primary, Estrella, Melanie, primary, Bosserdt, Maria, primary, Martus, Peter, primary, D. Dodd, Jonathan, primary, and Dewey, Marc, primary

Published
2023
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21. Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease

Author

Benedek, Theodora, primary, Wieske, Viktoria, additional, Szilveszter, Bálint, additional, Kofoed, Klaus F., additional, Donnelly, Patrick, additional, Rodriguez-Palomares, José, additional, Erglis, Andrejs, additional, Veselka, Josef, additional, Šakalytė, Gintarė, additional, Ađić, Nada Čemerlić, additional, Gutberlet, Matthias, additional, Diez, Ignacio, additional, Davis, Gershan, additional, Zimmermann, Elke, additional, Kępka, Cezary, additional, Vidakovic, Radosav, additional, Francone, Marco, additional, Ilnicka-Suckiel, Małgorzata, additional, Plank, Fabian, additional, Knuuti, Juhani, additional, Faria, Rita, additional, Schröder, Stephen, additional, Berry, Colin, additional, Saba, Luca, additional, Ruzsics, Balazs, additional, Rieckmann, Nina, additional, Kubiak, Christine, additional, Schultz Hansen, Kristian, additional, Müller-Nordhorn, Jacqueline, additional, Merkely, Bela, additional, Sigvardsen, Per E., additional, Benedek, Imre, additional, Orr, Clare, additional, Valente, Filipa Xavier, additional, Zvaigzne, Ligita, additional, Horváth, Martin, additional, Jankauskas, Antanas, additional, Ađić, Filip, additional, Woinke, Michael, additional, Mulvihill, Niall, additional, Lecumberri, Iñigo, additional, Thwaite, Erica, additional, Laule, Michael, additional, Kruk, Mariusz, additional, Stefanovic, Milica, additional, Mancone, Massimo, additional, Kuśmierz, Donata, additional, Feuchtner, Gudrun, additional, Pietilä, Mikko, additional, Ribeiro, Vasco Gama, additional, Drosch, Tanja, additional, Delles, Christian, additional, Melis, Marco, additional, Fisher, Michael, additional, Boussoussou, Melinda, additional, Kragelund, Charlotte, additional, Aurelian, Rosca, additional, Kelly, Stephanie, additional, Garcia del Blanco, Bruno, additional, Rubio, Ainhoa, additional, Károlyi, Mihály, additional, Hove, Jens D., additional, Rodean, Ioana, additional, Regan, Susan, additional, Calabria, Hug Cuéllar, additional, Gellér, László, additional, Larsen, Linnea, additional, Hodas, Roxana, additional, Napp, Adriane E., additional, Haase, Robert, additional, Feger, Sarah, additional, Mohamed, Mahmoud, additional, Serna-Higuita, Lina M., additional, Neumann, Konrad, additional, Dreger, Henryk, additional, Rief, Matthias, additional, Danesh, John, additional, Estrella, Melanie, additional, Bosserdt, Maria, additional, Martus, Peter, additional, Dodd, Jonathan D., additional, and Dewey, Marc, additional

Published
2023
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22. Age and Computed Tomography and Invasive Coronary Angiography in Stable Chest Pain: A Prespecified Secondary Analysis of the DISCHARGE Randomized Clinical Trial

Author

Bosserdt, Maria, Serna-Higuita, Lina M., Feuchtner, Gudrun, Merkely, Bela, Kofoed, Klaus F., Benedek, Theodora, Donnelly, Patrick, Rodriguez-Palomares, José, Erglis, Andrejs, Štechovský, Cyril, Šakalyte, Gintare, Adic, Nada Cemerlic, Gutberlet, Matthias, Dodd, Jonathan D., Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kepka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Malgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Hansen, Kristian Schultz, Müller-Nordhorn, Jacqueline, Szilveszter, Bálint, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Suchánek, Vojtech, Jankauskas, Antanas, Adic, Filip, Woinke, Michael, Hensey, Mark, Lecumberri, Iñigo, Thwaite, Erica, Laule, Michael, Kruk, Mariusz, Neskovic, Aleksandar N., Mancone, Massimo, Kusmierz, Donata, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Porcu, Maurizio, Fisher, Michael, Boussoussou, Melinda, Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, Garcia del Blanco, Bruno, Rubio, Ainhoa, Maurovich-Horvat, Pál, Hove, Jens D., Rodean, Ioana, Regan, Susan, Cuellar-Calabria, Hug, Molnár, Levente, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Estrella, Melanie, Martus, Peter, Sox, Harold C., and Dewey, Marc

Abstract

IMPORTANCE: The effectiveness and safety of computed tomography (CT) and invasive coronary angiography (ICA) in different age groups is unknown. OBJECTIVE: To determine the association of age with outcomes of CT and ICA in patients with stable chest pain. DESIGN, SETTING, AND PARTICIPANTS: The assessor-blinded Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) randomized clinical trial was conducted between October 2015 and April 2019 in 26 European centers. Patients referred for ICA with stable chest pain and an intermediate probability of obstructive coronary artery disease were analyzed in an intention-to-treat analysis. Data were analyzed from July 2022 to January 2023. INTERVENTIONS: Patients were randomly assigned to a CT-first strategy or a direct-to-ICA strategy. MAIN OUTCOMES AND MEASURES: MACE (ie, cardiovascular death, nonfatal myocardial infarction, or stroke) and major procedure-related complications. The primary prespecified outcome of this secondary analysis of age was major adverse cardiovascular events (MACE) at a median follow-up of 3.5 years. RESULTS: Among 3561 patients (mean [SD] age, 60.1 [10.1] years; 2002 female [56.2%]), 2360 (66.3%) were younger than 65 years, 982 (27.6%) were between ages 65 to 75 years, and 219 (6.1%) were older than 75 years. The primary outcome was MACE at a median (IQR) follow-up of 3.5 (2.9-4.2) years for 3523 patients (99%). Modeling age as a continuous variable, age, and randomization group were not associated with MACE (hazard ratio, 1.02; 95% CI, 0.98-1.07; P for interaction = .31). Age and randomization group were associated with major procedure-related complications (odds ratio, 1.15; 95% CI, 1.05-1.27; P for interaction = .005), which were lower in younger patients. CONCLUSIONS AND RELEVANCE: Age did not modify the effect of randomization group on the primary outcome of MACE but did modify the effect on major procedure-related complications. Results suggest that CT was associated with a lower risk of major procedure-related complications in younger patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02400229

Published
2024
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23. Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease

Author

Benedek, Theodora, Wieske, Viktoria, Szilveszter, Bálint, Kofoed, Klaus F., Donnelly, Patrick, Rodriguez-Palomares, José, Erglis, Andrejs, Veselka, Josef, Šakalytė, Gintarė, Ađić, Nada Čemerlić, Gutberlet, Matthias, Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Schultz Hansen, Kristian, Müller-Nordhorn, Jacqueline, Merkely, Bela, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Horváth, Martin, Jankauskas, Antanas, Ađić, Filip, Woinke, Michael, Mulvihill, Niall, Lecumberri, Iñigo, Thwaite, Erica, Laule, Michael, Kruk, Mariusz, Stefanovic, Milica, Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Melis, Marco, Fisher, Michael, Boussoussou, Melinda, Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, Garcia Del Blanco, Bruno, Rubio, Ainhoa, Károlyi, Mihály, Hove, Jens D., Rodean, Ioana, Regan, Susan, Calabria, Hug Cuéllar, Gellér, László, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Danesh, John, Estrella, Melanie, Bosserdt, Maria, Martus, Peter, Dodd, Jonathan D., Dewey, Marc, Benedek, Theodora, Wieske, Viktoria, Szilveszter, Bálint, Kofoed, Klaus F., Donnelly, Patrick, Rodriguez-Palomares, José, Erglis, Andrejs, Veselka, Josef, Šakalytė, Gintarė, Ađić, Nada Čemerlić, Gutberlet, Matthias, Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Rieckmann, Nina, Kubiak, Christine, Schultz Hansen, Kristian, Müller-Nordhorn, Jacqueline, Merkely, Bela, Sigvardsen, Per E., Benedek, Imre, Orr, Clare, Valente, Filipa Xavier, Zvaigzne, Ligita, Horváth, Martin, Jankauskas, Antanas, Ađić, Filip, Woinke, Michael, Mulvihill, Niall, Lecumberri, Iñigo, Thwaite, Erica, Laule, Michael, Kruk, Mariusz, Stefanovic, Milica, Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Ribeiro, Vasco Gama, Drosch, Tanja, Delles, Christian, Melis, Marco, Fisher, Michael, Boussoussou, Melinda, Kragelund, Charlotte, Aurelian, Rosca, Kelly, Stephanie, Garcia Del Blanco, Bruno, Rubio, Ainhoa, Károlyi, Mihály, Hove, Jens D., Rodean, Ioana, Regan, Susan, Calabria, Hug Cuéllar, Gellér, László, Larsen, Linnea, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Mohamed, Mahmoud, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Danesh, John, Estrella, Melanie, Bosserdt, Maria, Martus, Peter, Dodd, Jonathan D., and Dewey, Marc

Abstract

OBJECTIVE To compare cardiac computed tomography (CT) with invasive coronary angiography (ICA) as the initial strategy in patients with diabetes and stable chest pain. RESEARCH DESIGN AND METHODS This prespecified analysis of the multicenter DISCHARGE trial in 16 European countries was performed in patients with stable chest pain and intermediate pretest probability of coronary artery disease. The primary end point was a major adverse cardiac event (MACE) (cardiovascular death, nonfatal myocardial infarction, or stroke), and the secondary end point was expanded MACE (including transient ischemic attacks and major procedure-related complications). RESULTS Follow-up at a median of 3.5 years was available in 3,541 patients of whom 557 (CT group n = 263 vs. ICA group n = 294) had diabetes and 2,984 (CT group n = 1,536 vs. ICA group n = 1,448) did not. No statistically significant diabetes interaction was found for MACE (P = 0.45), expanded MACE (P = 0.35), or major procedure-related complications (P = 0.49). In both patients with and without diabetes, the rate of MACE did not differ between CT and ICA groups. In patients with diabetes, the expanded MACE end point occurred less frequently in the CT group than in the ICA group (3.8% [10 of 263] vs. 8.2% [24 of 294], hazard ratio [HR] 0.45 [95% CI 0.22–0.95]), as did the major procedure-related complication rate (0.4% [1 of 263] vs. 2.7% [8 of 294], HR 0.30 [95% CI 0.13 – 0.63]). CONCLUSIONS In patients with diabetes referred for ICA for the investigation of stable chest pain, a CT-first strategy compared with an ICA-first strategy showed no difference in MACE and may potentially be associated with a lower rate of expanded MACE and major procedure-related complications., OBJECTIVE: To compare cardiac computed tomography (CT) with invasive coronary angiography (ICA) as the initial strategy in patients with diabetes and stable chest pain. RESEARCH DESIGN AND METHODS: This prespecified analysis of the multicenter DISCHARGE trial in 16 European countries was performed in patients with stable chest pain and intermediate pretest probability of coronary artery disease. The primary end point was a major adverse cardiac event (MACE) (cardiovascular death, nonfatal myocardial infarction, or stroke), and the secondary end point was expanded MACE (including transient ischemic attacks and major procedure-related complications). RESULTS: Follow-up at a median of 3.5 years was available in 3,541 patients of whom 557 (CT group n = 263 vs. ICA group n = 294) had diabetes and 2,984 (CT group n = 1,536 vs. ICA group n = 1,448) did not. No statistically significant diabetes interaction was found for MACE (P = 0.45), expanded MACE (P = 0.35), or major procedure-related complications (P = 0.49). In both patients with and without diabetes, the rate of MACE did not differ between CT and ICA groups. In patients with diabetes, the expanded MACE end point occurred less frequently in the CT group than in the ICA group (3.8% [10 of 263] vs. 8.2% [24 of 294], hazard ratio [HR] 0.45 [95% CI 0.22-0.95]), as did the major procedure-related complication rate (0.4% [1 of 263] vs. 2.7% [8 of 294], HR 0.30 [95% CI 0.13 - 0.63]). CONCLUSIONS: In patients with diabetes referred for ICA for the investigation of stable chest pain, a CT-first strategy compared with an ICA-first strategy showed no difference in MACE and may potentially be associated with a lower rate of expanded MACE and major procedure-related complications.

Published
2023

25. The Impact of Novel Reconstruction Algorithms on Calcium Scoring: Results on a Dedicated Cardiac CT Scanner

Author

Vecsey-Nagy, Milán, primary, Jokkel, Zsófia, additional, Jermendy, Ádám Levente, additional, Nagy, Martin, additional, Boussoussou, Melinda, additional, Vattay, Borbála, additional, Kolossváry, Márton, additional, Csobay-Novák, Csaba, additional, Amin-Spector, Sigal, additional, Merkely, Béla, additional, and Szilveszter, Bálint, additional

Published
2023
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26. Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner

Author

Panajotu, Alexisz, primary, Vecsey-Nagy, Milán, additional, Jermendy, Ádám Levente, additional, Boussoussou, Melinda, additional, Vattay, Borbála, additional, Kolossváry, Márton, additional, Zs. Dombrády, Örs, additional, Csobay-Novák, Csaba, additional, Merkely, Béla, additional, and Szilveszter, Bálint, additional

Published
2023
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28. Evaluating the prognostic value of coronary CT angiography derived fractional flow reserve in patient with myocardial infarction

Author

Boussoussou, Melinda

Subjects
Comparative studies, Cardiovascular system, Ischaemia / Infarction, Haemodynamics / Flow dynamics, Cardiac, CT-Angiography
Abstract

Purpose Methods and materials Results Conclusion Personal information and conflict of interest References, Purpose: Fractional Flow Reserve (FFR) guided intervention of non-IRA lesions might be superior to conservative therapy in preventing major adverse cardiac events (MACE). However the proper timing of the intervention is still under debate. Moreover, it is...

Published
2023
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30. Heart Rate-Dependent Degree of Motion Artifacts in Coronary CT Angiography Acquired by a Novel Purpose-Built Cardiac CT Scanner

Author

Vecsey-Nagy, Milán, primary, Jermendy, Ádám Levente, additional, Kolossváry, Márton, additional, Vattay, Borbála, additional, Boussoussou, Melinda, additional, Suhai, Ferenc Imre, additional, Panajotu, Alexisz, additional, Csőre, Judit, additional, Borzsák, Sarolta, additional, Fontanini, Daniele Mariastefano, additional, Csobay-Novák, Csaba, additional, Merkely, Béla, additional, Maurovich-Horvat, Pál, additional, and Szilveszter, Bálint, additional

Published
2022
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31. CT or invasive coronary angiography in stable chest pain

Author

Maurovich-Horvat, Pál, Bosserdt, Maria, Kofoed, Klaus F., Rieckmann, Nina, Benedek, Theodora, Donnelly, Patrick, Rodriguez-Palomares, José, Erglis, Andrejs, Štěchovský, Cyril, Šakalyte, Gintare, Čemerlić Adić, Nada, Gutberlet, Matthias, Dodd, Jonathan D., Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Kubiak, Christine, Gutierrez-Ibarluzea, Iñaki, Schultz Hansen, Kristian, Müller-Nordhorn, Jacqueline, Merkely, Bela, Knudsen, Andreas D., Benedek, Imre, Orr, Clare, Xavier Valente, Filipa, Zvaigzne, Ligita, Suchánek, Vojtěch, Zajančkauskiene, Laura, Adić, Filip, Woinke, Michael, Hensey, Mark, Lecumberri, Iñigo, Thwaite, Erica, Laule, Michael, Kruk, Mariusz, Neskovic, Aleksandar N., Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Gama Ribeiro, Vasco, Drosch, Tanja, Delles, Christian, Matta, Gildo, Fisher, Michael, Szilveszter, Bálint, Larsen, Linnea, Ratiu, Mihaela, Kelly, Stephanie, Garcia del Blanco, Bruno, Rubio, Ainhoa, Drobni, Zsófia D., Jurlander, Birgit, Rodean, Ioana, Regan, Susan, Cuéllar Calabria, Hug, Boussoussou, Melinda, Engstrøm, Thomas, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Estrella, Melanie, Martus, Peter, and Dewey, Marc

Abstract

Background: \ud In the diagnosis of obstructive coronary artery disease (CAD), computed tomography (CT) is an accurate, noninvasive alternative to invasive coronary angiography (ICA). However, the comparative effectiveness of CT and ICA in the management of CAD to reduce the frequency of major adverse cardiovascular events is uncertain.\ud \ud Methods: \ud We conducted a pragmatic, randomized trial comparing CT with ICA as initial diagnostic imaging strategies for guiding the treatment of patients with stable chest pain who had an intermediate pretest probability of obstructive CAD and were referred for ICA at one of 26 European centers. The primary outcome was major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) over 3.5 years. Key secondary outcomes were procedure-related complications and angina pectoris.\ud \ud Results: \ud Among 3561 patients (56.2% of whom were women), follow-up was complete for 3523 (98.9%). Major adverse cardiovascular events occurred in 38 of 1808 patients (2.1%) in the CT group and in 52 of 1753 (3.0%) in the ICA group (hazard ratio, 0.70; 95% confidence interval [CI], 0.46 to 1.07; P=0.10). Major procedure-related complications occurred in 9 patients (0.5%) in the CT group and in 33 (1.9%) in the ICA group (hazard ratio, 0.26; 95% CI, 0.13 to 0.55). Angina during the final 4 weeks of follow-up was reported in 8.8% of the patients in the CT group and in 7.5% of those in the ICA group (odds ratio, 1.17; 95% CI, 0.92 to 1.48).\ud \ud Conclusions: \ud Among patients referred for ICA because of stable chest pain and intermediate pretest probability of CAD, the risk of major adverse cardiovascular events was similar in the CT group and the ICA group. The frequency of major procedure-related complications was lower with an initial CT strategy. (Funded by the European Union Seventh Framework Program and others; DISCHARGE ClinicalTrials.gov number, NCT02400229.

Published
2022

32. The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study

Author

Vattay, Borbála, primary, Nagy, Anikó Ilona, additional, Apor, Astrid, additional, Kolossváry, Márton, additional, Manouras, Aristomenis, additional, Vecsey-Nagy, Milán, additional, Molnár, Levente, additional, Boussoussou, Melinda, additional, Bartykowszki, Andrea, additional, Jermendy, Ádám L., additional, Kováts, Tímea, additional, Zsarnóczay, Emese, additional, Maurovich-Horvat, Pál, additional, Merkely, Béla, additional, and Szilveszter, Bálint, additional

Published
2022
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34. Extracardiac findings on cardiac computed tomography in patients undergoing atrial fibrillation catheter ablation

Author

Simon, Judit, primary, Herczeg, Szilvia, additional, Borzsák, Sarolta, additional, Csőre, Judit, additional, Kardos, Anna Sára, additional, Mérges, Gergely, additional, Zsarnóczay, Emese, additional, Szegedi, Nándor, additional, Boussoussou, Melinda, additional, Vattay, Borbála, additional, Kolossváry, Márton, additional, Szilveszter, Bálint, additional, Gellér, László, additional, Merkely, Béla, additional, and Maurovich-Horvat, Pál, additional

Published
2022
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36. Model-based adaptive filter for a dedicated cardiovascular CT scanner: assessment of image noise, sharpness and quality

Author

Vecsey-Nagy, Milán, primary, Levente Jermendy, Ádám, additional, Imre Suhai, Ferenc, additional, Panajotu, Alexisz, additional, Csőre, Judit, additional, Borzsák, Sarolta, additional, Mariastefano Fontanini, Daniele, additional, Kolossváry, Márton, additional, Vattay, Borbála, additional, Boussoussou, Melinda, additional, Csobay-Novák, Csaba, additional, Merkely, Béla, additional, Maurovich-Horvat, Pál, additional, and Szilveszter, Bálint, additional

Published
2021
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39. Coronary plaque burden of the left anterior descending artery in patients with or without myocardial bridge: A case-control study based on coronary CT-angiography

Author

Papp, Sára, primary, Bárczi, György, additional, Karády, Júlia, additional, Kolossváry, Márton, additional, Drobni, Zsófia D., additional, Simon, Judit, additional, Boussoussou, Melinda, additional, Vattay, Borbála, additional, Szilveszter, Bálint, additional, Jermendy, György, additional, Merkely, Béla, additional, and Maurovich-Horvat, Pál, additional

Published
2021
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43. Cost-effectiveness of ultrahigh-resolution photon-counting detector coronary CT angiography for the evaluation of stable chest pain.

Author

Vecsey-Nagy M, Emrich T, Tremamunno G, Kravchenko D, Taha Hagar M, Laux GS, Schoepf UJ, O'Doherty J, Boussoussou M, Szilveszter B, Maurovich-Horvat P, Kroencke T, Kabakus IM, Spruill Suranyi P, Varga-Szemes A, and Decker JA

Abstract

Background: The increased specificity of ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT over energy-integrating detector (EID)-CT for coronary CT angiography (CCTA) could defer unwarranted downstream tests. The objective of the study was to simulate the cost-effectiveness of UHR CCTA in stable chest pain patients with coronary calcifications., Methods: A decision and simulation model was developed using Monte Carlo simulations with 1000 bootstrap resamples to estimate the costs associated with PCD-CT in lieu of EID-CT for CCTA and the referral for subsequent testing. The model was constructed using the diagnostic accuracy metrics of 55 coronary lesions in patients who underwent CCTA on both CT systems and subsequent invasive coronary angiography (ICA). Sensitivity and specificity were defined for each Coronary Artery Disease Reporting and Data System category. The aggregate healthcare expenditures were derived from the hospital billing system., Results: Assuming a projected cohort of 15,000 patients over the lifetime of the PCD-CT, its implementation resulted in a 18.9 ​% reduction in the number of functional follow-up tests (6330.3 ​± ​59.5 vs. 5135.7 ​± ​60.6, p ​< ​0.001), a 6.0 ​% reduction in performed ICAs (1447.7 ​± ​36.2 vs. 1360.2 ​± ​34.7, p ​< ​0.001), and a 9.4 ​% decrease in major procedure-related complications. Over a 10-year expected life expectancy, PCD-CT led to an average cost saving of $794.50 ​± ​18.50 per patient and an overall cost difference of $11,917,500 ​± ​4,350,169., Conclusions: PCD-CT has the potential to reduce the financial burden on healthcare systems and procedure-related complications for stable chest pain patients with coronary calcification when compared to EID-CT., Competing Interests: Declaration of competing interest Dr. Schoepf receives institutional research support and/or honoraria for speaking and consulting from Bayer, Bracco, Elucid BioImaging, Guerbet, HeartFlow Inc., Keya Medical, and Siemens Healthineers. Dr. Szilveszter was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and receives institutional research and travel support from Siemens Healthineers. Dr. Maurovich-Horvat receives institutional research and travel support from Siemens Healthineers. Dr. Varga-Szemes receives institutional research and travel support from Siemens Healthineers and is a consultant and shareholder for Elucid Bioimaging. Dr. Emrich is a consultant for Circle Cardiovascular Imaging Inc. and receives travel support, speaker fee and institutional research support from Siemens Healthineers., (Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Published
2024
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44. Coronary Artery Calcium Score Predicts Major Adverse Cardiovascular Events in Stable Chest Pain.

Author

Biavati F, Saba L, Boussoussou M, Kofoed KF, Benedek T, Donnelly P, Rodríguez-Palomares J, Erglis A, Štěchovský C, Šakalytė G, Čemerlić Ađić N, Gutberlet M, Dodd JD, Diez I, Davis G, Zimmermann E, Kępka C, Vidakovic R, Francone M, Ilnicka-Suckiel M, Plank F, Knuuti J, Faria R, Schröder S, Berry C, Ruzsics B, Rieckmann N, Kubiak C, Hansen KS, Müller-Nordhorn J, Maurovich-Horvat P, Sigvardsen PE, Benedek I, Orr C, Valente FX, Zvaigzne L, Suchánek V, Jankauskas A, Ađić F, Woinke M, Cadogan D, Lecumberri I, Thwaite E, Kruk M, Neskovic AN, Mancone M, Kuśmierz D, Feuchtner G, Pietilä M, Ribeiro VG, Drosch T, Delles C, Cau R, Fisher M, Merkely B, Kragelund C, Aurelian R, Kelly S, García Del Blanco B, Rubio A, Szilveszter B, Hove JD, Rodean I, Regan S, Cuéllar Calabria H, Édes IF, Larsen L, Hodas R, Napp AE, Haase R, Feger S, Mohamed M, Serna-Higuita LM, Neumann K, Dreger H, Rief M, Wieske V, Budoff MJ, Estrella M, Martus P, Bosserdt M, and Dewey M

Subjects
Adult, Humans, Female, Middle Aged, Calcium, Chest Pain diagnostic imaging, Coronary Artery Disease diagnostic imaging, Myocardial Infarction
Abstract

Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA. Participants were randomly assigned to undergo either ICA or coronary CT. CAC scores from noncontrast CT scans were categorized into low, intermediate, and high groups based on scores of 0, 1-399, and 400 or higher, respectively. The end point of the study was the occurrence of MACE (myocardial infarction, stroke, and cardiovascular death) over a median 3.5-year follow-up, analyzed using Cox proportional hazard regression tests. Results The study involved 1749 participants (mean age, 60 years ± 10 [SD]; 992 female). The prevalence of obstructive coronary artery disease (CAD) at CT angiography rose from 4.1% (95% CI: 2.8, 5.8) in the CAC score 0 group to 76.1% (95% CI: 70.3, 81.2) in the CAC score 400 or higher group. Revascularization rates increased from 1.7% to 46.2% across the same groups ( P < .001). The CAC score 0 group had a lower MACE risk (0.5%; HR, 0.08 [95% CI: 0.02, 0.30]; P < .001), as did the 1-399 CAC score group (1.9%; HR, 0.27 [95% CI: 0.13, 0.59]; P = .001), compared with the 400 or higher CAC score group (6.8%). No significant difference in MACE between sexes was observed ( P = .68). Conclusion In participants with stable chest pain initially referred for ICA, a CAC score of 0 showed very low risk of MACE, and higher CAC scores showed increasing risk of obstructive CAD, revascularization, and MACE at follow-up. Clinical trial registration no. NCT02400229 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Hanneman and Gulsin in this issue.

Published
2024
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45. CT or Invasive Coronary Angiography in Stable Chest Pain.

Author

Maurovich-Horvat P, Bosserdt M, Kofoed KF, Rieckmann N, Benedek T, Donnelly P, Rodriguez-Palomares J, Erglis A, Štěchovský C, Šakalyte G, Čemerlić Adić N, Gutberlet M, Dodd JD, Diez I, Davis G, Zimmermann E, Kępka C, Vidakovic R, Francone M, Ilnicka-Suckiel M, Plank F, Knuuti J, Faria R, Schröder S, Berry C, Saba L, Ruzsics B, Kubiak C, Gutierrez-Ibarluzea I, Schultz Hansen K, Müller-Nordhorn J, Merkely B, Knudsen AD, Benedek I, Orr C, Xavier Valente F, Zvaigzne L, Suchánek V, Zajančkauskiene L, Adić F, Woinke M, Hensey M, Lecumberri I, Thwaite E, Laule M, Kruk M, Neskovic AN, Mancone M, Kuśmierz D, Feuchtner G, Pietilä M, Gama Ribeiro V, Drosch T, Delles C, Matta G, Fisher M, Szilveszter B, Larsen L, Ratiu M, Kelly S, Garcia Del Blanco B, Rubio A, Drobni ZD, Jurlander B, Rodean I, Regan S, Cuéllar Calabria H, Boussoussou M, Engstrøm T, Hodas R, Napp AE, Haase R, Feger S, Serna-Higuita LM, Neumann K, Dreger H, Rief M, Wieske V, Estrella M, Martus P, and Dewey M

Subjects
Angina Pectoris diagnostic imaging, Angina Pectoris etiology, Chest Pain diagnostic imaging, Chest Pain etiology, Female, Humans, Male, Coronary Angiography adverse effects, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Tomography, X-Ray Computed adverse effects
Abstract

Background: In the diagnosis of obstructive coronary artery disease (CAD), computed tomography (CT) is an accurate, noninvasive alternative to invasive coronary angiography (ICA). However, the comparative effectiveness of CT and ICA in the management of CAD to reduce the frequency of major adverse cardiovascular events is uncertain., Methods: We conducted a pragmatic, randomized trial comparing CT with ICA as initial diagnostic imaging strategies for guiding the treatment of patients with stable chest pain who had an intermediate pretest probability of obstructive CAD and were referred for ICA at one of 26 European centers. The primary outcome was major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) over 3.5 years. Key secondary outcomes were procedure-related complications and angina pectoris., Results: Among 3561 patients (56.2% of whom were women), follow-up was complete for 3523 (98.9%). Major adverse cardiovascular events occurred in 38 of 1808 patients (2.1%) in the CT group and in 52 of 1753 (3.0%) in the ICA group (hazard ratio, 0.70; 95% confidence interval [CI], 0.46 to 1.07; P = 0.10). Major procedure-related complications occurred in 9 patients (0.5%) in the CT group and in 33 (1.9%) in the ICA group (hazard ratio, 0.26; 95% CI, 0.13 to 0.55). Angina during the final 4 weeks of follow-up was reported in 8.8% of the patients in the CT group and in 7.5% of those in the ICA group (odds ratio, 1.17; 95% CI, 0.92 to 1.48)., Conclusions: Among patients referred for ICA because of stable chest pain and intermediate pretest probability of CAD, the risk of major adverse cardiovascular events was similar in the CT group and the ICA group. The frequency of major procedure-related complications was lower with an initial CT strategy. (Funded by the European Union Seventh Framework Program and others; DISCHARGE ClinicalTrials.gov number, NCT02400229.)., (Copyright © 2022 Massachusetts Medical Society.)

Published
2022
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46. [Historical overview of medical meteorology - the new horizon in medical prevention].

Author

Boussoussou N, Boussoussou M, and Nemes A

Subjects
Atmospheric Pressure, Environmental Exposure adverse effects, Environmental Monitoring, Greenhouse Effect, Humans, Meteorological Concepts, Primary Health Care organization & administration, Primary Prevention organization & administration
Abstract

The aim of this article is to draw attention to the medical meteorology from the perspective of the history of science. Unfortunately medical meteorology is not part of the daily medical practice. The climate change is a new challenge for health care worldwide. It concerns millions of people a higher morbidity and mortality rate. Knowing the effects of the meteorological parameters as risk factors can allow us to create new prevention strategies. These new strategies could help to decrease the negative health effects of the meteorological parameters. Nowadays on the field of the medical prevention the medical meteorology is a new horizon and in the future it could play an important role. Health care professionals have the most important role to fight against the negative effects of the global climate change. Orv. Hetil., 2017, 158(5), 187-191.

Published
2017
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