right thanks for having me i must
have sram the eastern letter this bake
a hot and bicycle or center
i'm very happy to share with your
some information about our recent study that
was recently published and jack imaging
in this study we looked at nearly
four thousand patients for under one should
both but my kind that profusion imaging
you think are beat him eighty two
as well as coronary artery custom scoring
the same setting you followed these patients
for the outcome said that list of
than our study
right back back than nonfatal my card
then infection and we wanted to see
f football custom scoring as well as
but my of issues and imaging as
specifically mike either fla deserve to the
outcomes
what we noted in our state is
that sam nearly thirty six percent of
the patients had a custom score of
zero and sixteen percent had cousins come
more than four hundred
but we also had nearly forty three
percent had my kind of flawed their
fullest and to we followed our patients
for nearly two years done
one hundred thirty patients experience either cardiac
death or mac or that and function
and as shown in the central illustration
of our paper
both coronary artery castle scoring and my
kind of florida have added including mental
prognostic value of are both the clinical
and to fusion your valuables there was
significant naturally classification for both
and and there was also additional information
for prognosis by combining can by adding
either one
in our study we could not pass
see a statistical significance from combining both
of them namely coronary artery cause from
scoring and my car that florida reserve
on top of each other
so the main point here is that
it is very important that we assess
bought my car the diffusion and the
jank am i kind of florida
but also the same time assess the
yeah
extent of atherosclerosis using coronary artery calcium
scoring because the as an inkling mental
prognostic value and help us risk stratified
these patients
many colleagues looking at the study
first of all commonly and should we
do coronary artery customs kaliningrad chile when
we do at my car that issues
and imaging and answer is yes we
always recommend that we do coronary artery
costumes claim that is there are data
not included in our study it
are looking at incremental diagnostic manual and
here we are showing incremental prognostic value
so technically you gain a lot by
adding coronary artery castles correct you have
a fusion as data it adds incremental
prague know
ah stick value because it helps predict
the patients school experience current cardiac death
or myocardial infarction
the second question that comes always like
how often do i need to been
added to discuss from scoring like if
a patient had it recently and if
the patient had it with a six
month we don't usually routinely do it
but we know that that extent
of atherosclerosis the similar ah from the
sad it's not gonna progress significantly over
a six month period anything longer than
that we return routinely do it
and there are
a set of guidelines that so will
be coming out from as nick and
multiple other professional societies that will help
showed a discuss the incremental diagnostic and
prognostic value of the is and how
these procedures should be done coronary artery
kasem scoring and with setting off my
are there profusion imaging or what are
the best practices in terms of addicting
yeah how to interpret them and how
to best utilize suddenly you're clinical practice
yeah this data is very relevant because
unfortunately many my god the pictures and
imaging procedures are down without the testament
off extent of coronary atherosclerosis and we
have other day to them but all
still here we can get back to
what determines a long term prognostic value
of these patients is actually the extent
of atherosclerosis
a scheme me as very helpful to
determine if the patient requires your vascular
station if that patient symptoms are coming
from my cargo scheme yeah but the
extent of atherosclerosis as assessed or by
coronary artery cause scoring is extremely helpful
an assessment of risk of these patients
long term it will help guy at
will help guide the medical management of
the a patient i'm not only that
many can measure but the intensity of
medical management i'll give you a couple
examples a patient with
as a small perfusion defect but the
zero cats from score
this is very helpful because you know
that this patient has gonna do while
because that long term councils quarters zero
and the long term event rate as
low on the other and a patient
with normal my cognitive diffusion imaging as
we had many and the study
dot that gas him score more than
a thousand and will identify a high
risk patient
neither did the of the a special
to require intervention and they would be
good with medical therapy but the patient
with no motor fusion and the very
high cost score will have a high
and men three inch long term because
of the increased extent of coronary atherosclerosis
this is on top of what we
know
from fusion imaging as we show in
our study
it's very important to know that koran
that after sclerosis takes time to develop
and progress and we would love to
see the impact of medical therapy on
his patients are those patients with very
high accuracy clear arctic burden destined to
worse outcome or weekend
improved their long term outcome by aggressive
medical fit be think clothes significant control
of blood pressure of dad beat us
and has written us decreasing i'll be
i'll be lost seventeen milligrams per deciliter
what that improve
in the outcome of this one than
improving the risk profile of these patients
with significant atherosclerosis respective whether the have
perfusion and with a motor fusion imaging
or normal occasion imaging when impact that
outcome is something we don't know at
this point that have been some
hence from other studies i would love
to see studies that well determine ah
the impact of
the medical therapy on description us with
at vassar strudel says on the other
and them and a very thought provoking
idea that will probably require additional testing
and a randomized trial a clinical trial
setting is what about those speeches was
the
look awesome score at outcome this is
very good and should we stop at
that point and potentially not do the
my a cadet precision imaging dance this
of significant the scheme and this group
is extremely law which is usually less
son
five percent or so and mood sometimes
even less than one person and depends
on the seat is you're studying or
whether holding the due to do my
conduct of fusion imaging and his patient
would have any impact on the diagnostic
accuracy or on that long term out
cut short
and long term outcome of these patients
is very important to study
a one just emphasize that gun the
same message on been talking about for
the past few minutes who chairs always
assess atherosclerosis when you do my cargo
to church an imaging as those is
extremely employ
orton this can be none in multiple
ways you can do it by looking
at doing get traditional score years and
the august two method while doing at
my kind of to choose and imaging
or even spec my credit for fusion
energy as we've done and this study
but you can always
just as the cp attenuation go russia
the low dose city it to cook
to work as a rough estimate of
the amount of calcium that isn't the
kind that he admitted with three and
that would be very helpful to identify
those patients that might be at a
higher risk of a fan
because of high atherosclerotic burden always always
always in conjunction with at where my
occurred a profusion imaging we should do
at risk losses burden assessment and patients
without knowing see any i just want
to emphasize also that the says
only for patients without not see the
one suggestion is known to have obstructive
car disease and the already had no
pc i or bypass surgery and and
this whole discussion is not relevant for
this patient and you thought a different
sub group of patients batch should be
assessed and a different way