Computed tomography angiography and coronary artery disease-reporting and data system and a 5-year prognostic major adverse cardiovascular and cerebral event outcome study in a symptomatic Southeast Asian population.

Background: This study investigated the relationship between coronary artery disease-reporting and data system (CAD-RADS) for coronary computed tomography angiogram (CCTA) and major adverse cardiovascular and cerebral event (MACE) in a symptomatic Southeast Asian, Thai population over a 5-year period.

Methods: A retrospective cohort study of Thai patients without known CAD who underwent CCTA for CAD symptoms. CCTA images and 5-year health data were reviewed for CAD-RADS and MACE. MACE consists of all-cause mortality, cardiovascular death, acute coronary syndrome, heart failure hospitalization, and stroke.

Results: In total 336 patients were evaluated. The median follow-up period was 6.4 years. The overall MACE incidence was 63 cases (18.8%). The MACE event rate was progressively increased with higher CAD-RADS categories; CAD-RADS 3 [hazard ratio (HR), 3.62; P  = 0.015], CAD-RADS 4a (HR, 3.50; P  = 0.024), CAD-RADS 4b & 5 (HR, 7.56; P  = 0.001). The risk of MACE increased significantly in the moderate to severe CAD burden group (HR, 5.58; P  = 0.01). Kaplan-Meier curve showed a significant rise in MACE with higher CAD-RADS categories ( P  = 0.01).

Conclusions: CAD-RADS classification has a significant prognostic value in Southeast Asian, Thai population with cardiac symptoms.