An exploratory analysis of the utility of maximum degree of stenosis on computed tomography coronary angiography for predicting major adverse cardiac events
Faulder, Thomas, Prematunga, Shiromi, Moloi, Soniah, and Moxon, Joseph (2025) An exploratory analysis of the utility of maximum degree of stenosis on computed tomography coronary angiography for predicting major adverse cardiac events. BMC Medical Imaging, 25. 483.
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Abstract
Introduction: The strength of CT coronary angiography (CTCA) is ruling out significant coronary artery disease (CAD) in symptomatic intermediate risk patients. CTCA is gaining attention as a tool for stratifying patients’ risk of major adverse cardiac events (MACE). This study evaluated the ability of stenosis reporting on CTCA to predict MACE in patients undergoing investigation at Townsville University Hospital. Methods and results: One-thousand and three patients (1003) who underwent a CTCA between January 2015 and November 2023 were followed up until February 2024. For each patient, maximum degree of stenosis on CTCA, coronary artery calcium score (CACS) and cardiac risk factors were collected. Four-hundred and seventy-one (471) patients had no stenosis on CTCA, 181 had 1–49% stenosis, 237 had 50–69% stenosis and 114 had 70% stenosis. One hundred and sixteen (116) patients had invasive coronary angiography (ICA) performed of which 29 had a subsequent percutaneous coronary intervention (PCI) and 9 had a coronary artery bypass graft (CABG). In patients with 70% or more stenosis on CTCA, the hazard ratio for suffering a three-point definition of MACE (all-cause mortality, myocardial infarction and stroke or TIA) was 3.74 compared to the 0% stenosis group. ROC curve analysis revealed similar performance of CTCA between subsets of the population. There was no statistically significant difference in the ability of CTCA to predict MACE between women and men, and between Aboriginal and/or Torres Strait Islander patients and other Australians. Conclusions: Maximum degree of stenosis on CTCA can predict MACE. The apparent predictive value of CTCA for MACE largely depends on the features extracted from CTCA and the definition of MACE used.
| Item ID: | 89872 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1471-2342 |
| Keywords: | Coronary artery calcium score, CT coronary angiography, Invasive coronary angiography, Major adverse cardiac events, Percutaneous coronary intervention and coronary artery bypass graft |
| Copyright Information: | © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. |
| Date Deposited: | 19 Jan 2026 22:44 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100% |
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