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

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. TheCoronary Artery Disease Reporting and Data Systems (CAD-RADS) was introduced to address the inconsistent CCTA re-ports. This systematic review with meta-analysis aimed to comprehensively appraise all available studies and draw con-clusions on the prognostic value of the CAD-RADS classification system in CAD patients.

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

16 articles were included in this system-atic 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, exceptCAD-RADS 1, can be a predictor of all-cause mortality (HRs ranged from 1.50 to 3.09). Moreover, higher CAD-RADScategories 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).

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