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Review
. 2023 Jun 15;11(1):e45.
doi: 10.22037/aaem.v11i1.1997. eCollection 2023.

The value of Coronary Artery Disease - Reporting and Data System (CAD-RADS) in Outcome Prediction of CAD Patients; a Systematic Review and Meta-analysis

Koohyar Ahmadzadeh  1   2 , Shayan Roshdi Dizaji  1   2 , Mohammad Kiah  1 , Mohamad Rashid  3 , Reza Miri  4 , Mahmoud Yousefifard  1   4
Affiliations
Review

The value of Coronary Artery Disease - Reporting and Data System (CAD-RADS) in Outcome Prediction of CAD Patients; a Systematic Review and Meta-analysis

Koohyar Ahmadzadeh et al. Arch Acad Emerg Med. .

Abstract

Introduction: Coronary computed tomographic angiography (CCTA) reporting has traditionally been operator-dependent, and no precise classification is broadly used for reporting Coronary Artery Disease (CAD) severity. The Coronary Artery Disease Reporting and Data Systems (CAD-RADS) was introduced to address the inconsistent CCTA reports. This systematic review with meta-analysis aimed to comprehensively appraise all available studies and draw conclusions on the prognostic value of the CAD-RADS classification system in CAD patients.

Method: Online databases of PubMed, Embase, Scopus, and Web of Science were searched until September 19th, 2022, for studies on the value of CAD-RADS categorization for outcome prediction of CAD patients.

Results: 16 articles were included in this systematic review, 14 of which had assessed the value of CAD-RADS in the prediction of major adverse cardiovascular events (MACE) and 3 articles investigated the outcome of all-cause mortality. Our analysis demonstrated that all original CAD-RADS categories can be a predictor of MACE [Hazard ratios (HR) ranged from 3.39 to 8.63] and all categories, except CAD-RADS 1, can be a predictor of all-cause mortality (HRs ranged from 1.50 to 3.09). Moreover, higher CAD-RADS categories were associated with an increased hazard ratio for unfavorable outcomes among CAD patients (p for MACE = 0.007 and p for all-cause mortality = 0.018).

Conclusion: The evidence demonstrated that the CAD-RADS classification system can be used to predict incidence of MACE and all-cause mortality. This indicates that the implementation of CAD-RADS into clinical practice, besides enhancing the communication between physicians and improving patient care, can also guide physicians in risk assessment of the patients and predicting their prognosis.

Keywords: CAD-RADS; Coronary artery disease; Reporting and Data System; Risk assessment.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) diagram
Figure 2
Figure 2
Value of CAD-RADS classification system in prediction of major adverse cardiovascular events in coronary artery disease patients. CAD-RADS: Coronary artery disease-reporting and data system; CI: Confidence interval; HR: Hazard ratio
Figure 3
Figure 3
Value of CAD-RADS classification system in prediction of all-cause mortality in coronary artery disease patients. CAD-RADS: Coronary artery disease-reporting and data system; CI: Confidence interval; HR: Hazard ratio
See this image and copyright information in PMC

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