Validation of Coronary Artery Disease Reporting and Data System (CAD-RADS) and Application of Coronary Artery Calcium Data and Reporting System (CAC-DRS) as New Standardized Tools in the Management of Coronary Artery Disease Patients

Noha Yahia Ebaid,1 Dalia Nabil Khalifa,1 Ahmad Sabry Ragheb,1 Magdy Mohamad Abdelsamie,2 Ahmed Mohamed Alsowey1 1Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 2Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Noha Yahia EbaidDepartment of Radiology, Faculty of Medicine, Zagazig University, Zagazig, EgyptTel +201064422995Email nohayahiaradio@gmail.comBackground and Objectives: The coronary artery disease reporting and data system (CAD-RADS) is intended to standardize the reporting of CCTA and the subsequent management guidelines of CAD. The present study was conducted to investigate the validation of CAD-RADS and the application of coronary calcium grading in CAD management.Patients and Methods: The current study is a single-center prospective study that involved 177 participants with chest pain who were submitted to coronary CT angiography (CCTA). Two reviewers independently assessed CCTA results and gave each patient a CAD-RADS category. The reference standard for determining the clinical utility of CAD-RADS was invasive coronary angiography (ICA). The inter-reviewer agreement (IRA) was tested using the intra-class correlation (ICC).Results: The study enrolled 111 cases with non-significant CAD and 66 cases with significant CAD based on ICA findings. According to the reviewer, the CAD-RADS had a sensitivity, specificity, and accuracy of 90.9 to 100%, 89.2 to 94.6%, and 93.16 to 93.2%, respectively, for predicting severe CAD. The IRA for CAD-RADS categories was excellent (ICC = 0.960). The best cut-off value for predicting severe CAD was CAD-RADS > 3. Significant relation between Ca and severe CAD (p< 0.001) was detected.Conclusion: The current study provides a good understanding of CAD-RADS as a standard tool with high diagnostic accuracy.Keywords: coronary, cardiovascular disease, Agatston, computed tomography, stenosi