Prognostic Value of AI-Based Quantitative Coronary CTA vs Human Reader-Based Visual Assessment

作者：Alexander R. van Rosendael, Rine Nakanishi, Jeroen J. Bax, Gianluca Pontone, Saima Mushtaq, Ronny R. Buechel, Christoph Gräni, Gudrun Feuchtner, Pietro G. Lacaita, Amit R. Patel, Cristiane Carvalho Singulane, Andrew D. Choi, Mouaz H. Al‐Mallah, Daniele Andreini, Ronald P. Karlsberg, Geoffrey W. Cho, Carlos Eduardo Rochitte, Mirvat Alasnag, Ashraf Hamdan, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Himanshu Gupta, Martin Hadamitzky, Omar Khalique, Dinesh Kalra, James D. Mills, Nick S. Nurmohamed, Paul Knaapen, Matthew J. Budoff, Kashif Shaikh, Enrico Martin, David German, Maros Ferencik, Andrew Oehler, Roderick C. Deaño, Prashant Nagpal, Marly van Assen, Carlo N. De Cecco, Vasileios Kamperidis, Borek Foldyna, Jan M. Brendel, Victor Cheng, Kelley R. Branch, Márcio Sommer Bittencourt, Sabha Bhatti, Venkateshwar Polsani, George Wesbey, Rhanderson Cardoso, Ron Blankstein, Augustin DeLago, Amit Pursnani, Amro Alsaid, Vasvi Singh, Melissa Aquino, Jisuk Park, Ibrahim Danad · 发表于：JACC. Cardiovascular imaging · 年份：2025 · DOI：10.1016/j.jcmg.2025.09.021 · 被引用次数：4 · 研究领域：Cardiac Imaging and Diagnostics、Atrial Fibrillation Management and Outcomes、Artificial Intelligence in Healthcare and Education

BACKGROUND: The severity and extent of whole heart coronary plaque volume and stenosis can be reliably measured by artificial intelligence-guided quantitative coronary computed tomography angiography (AI-QCT). Limited data are available on the potential incremental prognostic value compared with currently recommended qualitative coronary computed tomography angiography (CTA) reads and the coronary artery calcium score (CACS). OBJECTIVES: The aim of this study was to evaluate the prognostic value of AI-QCT compared with human coronary CTA reads, including the CAD-RADS (Coronary Artery Disease-Reporting and Data System), CACS, and the modified Duke Index. METHODS: CONFIRM2 (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) is a multicenter, international, observational cohort study of patients undergoing clinically indicated coronary CTA with follow-up for major adverse cardiac events (MACE). Asymptomatic patients and those with cardiac history were excluded. Coronary artery disease presence, extent, and composition were quantified by AI-QCT across the coronary tree, yielding 24 patient-, vessel-, and plaque-level variables. On the basis of prior analyses, noncalcified plaque burden and diameter stenosis were identified as the strongest predictors and combined for statistical modeling as "AI-QCT." Comparator computed tomography scores included CAD-RADS, CACS, and the modified Duke Index, whereas clinical...