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Integrated prediction of cardiovascular events by automated coronary plaque and pericoronary adipose tissue quantification from CT Angiography

Award Number: R01HL148787
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/15/2020
PERIOD OF PERFORMANCE END DATE: 03/31/2025

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Integrated prediction of cardiovascular events by automated coronary plaque and pericoronary adipose tissue quantification from CT Angiography - PROJECT SUMMARY Coronary artery disease remains the leading cause of death worldwide, and more than half of the individuals suffering myocardial infarction (heart attacks) have no premonitory symptoms. Studies of patients with coronary artery disease have traditionally focused only on the severity of narrowing (stenosis) of the coronary arteries by atherosclerotic plaques, rather than the adverse features of coronary plaques which are predisposed to rupture and precipitate myocardial infarction. Coronary CT Angiography (CTA) is a noninvasive test that allows assessment of both coronary stenosis and plaque characteristics. Currently, however, CTA is interpreted visually for stenosis. Quantitative measurements of CTA stenosis severity and plaque features are not part of current clinical routine. We propose to develop novel image processing algorithms for fully automated, robust quantification of coronary plaque features from CTA. We also propose to automatically quantify the characteristics of adipose tissue around the coronary arteries (pericoronary adipose tissue, PCAT), which have been shown to differentiate rupture-prone, high-risk coronary plaques from stable ones. We propose to apply machine learning methods to efficiently combine stenosis, plaque and PCAT features, along with patient clinical data, into a new integrated risk score for the prediction of future adverse cardiovascular events. We will evaluate this risk score in the real-world, prospective, landmark SCOT-HEART trial (including all 2073 patients in the CTA arm of the trial), with added external validation in large multicenter patient registries, with available CTA scans, clinical data, and followup for cardiovascular events (fatal and non-fatal myocardial infarction and cardiovascular death in a grand total of 7844 patients). We propose three specific aims: 1) To refine, expand and automate measurements of coronary plaque and lumen for the entire coronary artery tree, and to standardize measurement of plaque changes in serial CTA; 2) To evaluate the prognostic value of automatically-quantified plaque features and PCAT characteristics for the prediction of future MACE in the prospective SCOT-HEART trial and multicenter CTA registries; 3) To develop and evaluate with full external validation a new automated patient risk score—combining patient clinical data, CTA-measured quantitative plaque features and PCAT characteristics, using machine learning—for the prediction of future MACE events in the prospective SCOT-HEART trial and multicenter CTA registries. The proposed work will enable automated, multi-faceted and reproducible analysis of plaque, stenosis and PCAT from CTA, combined with objective risk scores reflecting likelihood of adverse cardiovascular events. This work will provide a novel, personalized, real-world paradigm that objectively and accurately identifies individual patients at risk of future cardiovascular events, from routine CTA imaging.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$2,479 )
2025	2023	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	WEST HOLLYWOOD	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	000	4	8/6/2025	NON-COMPETING CONTINUATION	-$2,479
														Subtotal = -$2,479

Issue Date FY: 2023 ( Subtotal = $895,508 )
2023	2023	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	WEST HOLLYWOOD	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	001	4	3/29/2023	NON-COMPETING CONTINUATION	$695,211
2023	2023	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	WEST HOLLYWOOD	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	002	4	3/31/2023	SUPPLEMENT FOR EXPANSION	$147,336
2023	2023	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	WEST HOLLYWOOD	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	000	3	12/19/2022	SUPPLEMENT FOR EXPANSION	$52,961
														Subtotal = $895,508

Issue Date FY: 2022 ( Subtotal = $695,211 )
2022	2022	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	LOS ANGELES	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	001	3	5/31/2022	NON-COMPETING CONTINUATION	$69,522
2022	2022	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	LOS ANGELES	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	000	3	3/22/2022	NON-COMPETING CONTINUATION	$625,689
														Subtotal = $695,211

Issue Date FY: 2021 ( Subtotal = $684,863 )
2021	2021	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	LOS ANGELES	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	000	2	3/23/2021	NON-COMPETING CONTINUATION	$684,863
														Subtotal = $684,863

Issue Date FY: 2020 ( Subtotal = $714,763 )
2020	2020	CEDARS-SINAI MEDICAL CENTER	8700 BEVERLY BLVD	LOS ANGELES	CA	90048	LOS ANGELES	USA	Cardiovascular Diseases Research	000	1	5/15/2020	NEW	$714,763
														Subtotal = $714,763

Grand Total All Awards = $2,987,866

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Integrated prediction of cardiovascular events by automated coronary plaque and pericoronary adipose tissue quantification from CT Angiography

Award Number: R01HL148787

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/15/2020

PERIOD OF PERFORMANCE END DATE: 03/31/2025

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