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OBJECTIVES: To assess the prognostic implications of standardized reporting systems for coronary computed tomography angiography (CCTA) and coronary artery calcium scores (CACS) in patients with stable chest pain. BACKGROUND: The Coronary Artery Disease Reporting And Data System (CAD-RADS) and Coronary Artery Calcium - Data and Reporting System (CAC-DRS) aim to improve communication of CACS and CCTA results, but its influence on prognostication is unknown. METHODS: Images from 1769 patients who underwent CCTA as part of the Scottish Computed Tomography of the HEART (SCOT-HEART) multi-center randomized controlled trial were assessed. CACS were classified as CAC-DRS 0 to 3 based on Agatston scores. CCTA were classified as CAD-RADS 0 to 5 based on the most clinically relevant finding per patient. The primary outcome was the five-year events of fatal and non-fatal myocardial infarction. RESULTS: Patients had a mean age of 58 ± 10 years and 56% were male. CAC-DRS 0, 1, 2 and 3 occurred in 642 (36%), 510 (29%), 239 (14%) and 379 (21%) patients respectively. CAD-RADS 0, 1, 2, 3, 4A, 4B and 5 occurred in 622 (35%), 327 (18%), 211 (12%), 165 (9%), 221 (12%), 42 (2%) and 181 (10%) patients respectively. Patients classified as CAC-DRS 3 were at an increased risk of fatal or non-fatal myocardial infarction compared to CAC-DRS 0 patients (hazard ratio (HR) 9.41; 95% confidence interval (CI) 3.24, 27.31; p 

Original publication




Journal article


J cardiovasc comput tomogr

Publication Date





3 - 11


Angina, Chest pain, Computed tomography, Computed tomography coronary angiography, Standardized reporting, Aged, Angina, Stable, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Female, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Prognosis, Radiology Information Systems, Randomized Controlled Trials as Topic, Reproducibility of Results, Retrospective Studies, Risk Assessment, Risk Factors, Scotland, Severity of Illness Index, Time Factors, Vascular Calcification