Radiology advances · 2024
Prognostic significance of CAD-RADS for patients with suspected coronary artery disease: A systematic review and meta-analysis.
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Kato Shingo, Azuma Mai, Horita Nobuyuki, Utsunomiya Daisuke
Аннотация
BACKGROUND: Coronary Artery Disease-Reporting and Data System (CAD-RADS) is a standardized reporting system that offers a structured method for interpreting and reporting results obtained through coronary computed tomography angiography. It has been deemed useful in the prognostication of patients with suspected coronary artery disease (CAD).
PURPOSE: The present meta-analysis sought to assess the prognostic value of CAD-RADS in individuals with suspected CAD.
MATERIALS AND METHODS: We conducted a systematic search of the electronic databases of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE. A random-effects model was implemented to evaluate the pooled hazard ratio (HR) for each CAD-RADS category and area under the receiver operating characteristics curve for predicting major adverse cardiovascular events.
RESULTS: Data from 37 596 coronary computed tomography angiography examinations from 13 studies were analyzed. During follow-up, 2,536 (6.7%) adverse events were observed. Pooled HRs for prediction of adverse events were significant for all CAD-RADS categories, with incremental increase in HRs with progressively higher categories. For prediction of all-cause mortality, all categories except CAD-RADS 1 showed significant HR compared with CAD-RADS 0. Combination of CAD-RADS to conventional clinical risk factors and CAC resulted in a high predictive capacity for adverse events (pooled area under the receiver operating characteristics curve: 0.82 ([95% confidence interval, 0.73-0.91]).
CONCLUSION: The CAD-RADS category imparts information on the CAD severity and shows incremental increase in HR for adverse events with progressively higher categories, especially beyond CAD-RADS4b.
PURPOSE: The present meta-analysis sought to assess the prognostic value of CAD-RADS in individuals with suspected CAD.
MATERIALS AND METHODS: We conducted a systematic search of the electronic databases of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE. A random-effects model was implemented to evaluate the pooled hazard ratio (HR) for each CAD-RADS category and area under the receiver operating characteristics curve for predicting major adverse cardiovascular events.
RESULTS: Data from 37 596 coronary computed tomography angiography examinations from 13 studies were analyzed. During follow-up, 2,536 (6.7%) adverse events were observed. Pooled HRs for prediction of adverse events were significant for all CAD-RADS categories, with incremental increase in HRs with progressively higher categories. For prediction of all-cause mortality, all categories except CAD-RADS 1 showed significant HR compared with CAD-RADS 0. Combination of CAD-RADS to conventional clinical risk factors and CAC resulted in a high predictive capacity for adverse events (pooled area under the receiver operating characteristics curve: 0.82 ([95% confidence interval, 0.73-0.91]).
CONCLUSION: The CAD-RADS category imparts information on the CAD severity and shows incremental increase in HR for adverse events with progressively higher categories, especially beyond CAD-RADS4b.