Ter Arkh. 2026 May 2;98(4):202-208. doi: 10.26442/00403660.2026.04.203573.
ABSTRACT
AIM: Development of a "Risk Score Scale" (RSS) to assess the risk of Major Adverse Cardiovascular Events (MACE) based on computed tomographic angiography (CTА) of the coronary arteries in patients with acute coronary syndrome.
MATERIALS AND METHODS: The study included 249 pаtients with acute coronary syndrome (77.5% of men, age 58.2±10.7 years). Myocardial infarction occurred in 73.5% of patients, unstable angina - in 26.5%. After percutaneous coronary intervention CTA was performed by 320 - row CT scanner. 30 CTА characteristics were determined.
RESULTS: During 39.1 [18.0; 57.4] months of follow-up, 28.5% patients had combined primary endpoint events (PEE) including nonfatal myocardial infarction, unstable angina, cardiac death, unplanned percutaneous coronary intervention, ischemic stroke. RSS was developed by ROC analysis of the significant CT predictors of PEE, which were determined using a univariate Cox model. The uncensored period was 305 days - 26 PEE. Using the Yuden method, cut-off values, AUC values, and other indicators were calculated for predictors. RSS included the following 8 most optimal predictors with their cut-off values and score values: "number of coronary arteries with plaques" >1.5 - 1.0 point; "maximum plaque length" >14.5 mm - 1.16 points; "total length of plaques" >22.5 mm - 1.17; "maximal coronary stenosis" >77.5% - 1.23; "number of plaques with ≥50% stenosis" >3,5 - 1.1; "minimum plaque density" <29.1 HU - 1.33; "number of plaques with spotty calcifications" >1.5 - 1.23; "number of low attenuation plaque <30 HU" >0.5 - 1.00. For the resulting RSS calculated threshold value was 3 points. A score of >3 points indicates a high risk of MACE: odds ratio 7.2, 95% CI 2.6-19.7 (p<0.0001).
CONCLUSION: The use of RSS is a new and practically significant technique that makes it possible to improve the risk stratification of adverse outcomes.
PMID:42107122 | DOI:10.26442/00403660.2026.04.203573