Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals

James K. Min, Troy M. Labounty, Millie J. Gomez, Stephan Achenbach, Mouaz Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Victor Cheng, Kavitha M. Chinnaiyan, Benjamin Chow, Ricardo Cury, Augustin Delago, Allison Dunning, Gudrun Feuchtner, Martin Hadamitzky, Jorg Hausleiter, Philipp Kaufmann, Yong Jin KimJonathon Leipsic, Fay Y. Lin, Erica Maffei, Gilbert Raff, Leslee J. Shaw, Todd C. Villines, Daniel S. Berman

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Abstract

Background: Coronary artery disease (CAD) diagnosis by coronary computed tomographic angiography (CCTA) is useful for identification of symptomatic diabetic individuals at heightened risk for death. Whether CCTA-detected CAD enables improved risk assessment of asymptomatic diabetic individuals beyond clinical risk factors and coronary artery calcium scoring (CACS) remains unexplored. Methods: From a prospective 12-center international registry of 27,125 individuals undergoing CCTA, we identified 400 asymptomatic diabetic individuals without known CAD. Coronary stenosis by CCTA was graded as 0%, 1-49%, 50-69%, and ≥70%. CAD was judged on a per-patient, per-vessel and per-segment basis as maximal stenosis severity, number of vessels with ≥50% stenosis, and coronary segments weighted for stenosis severity (segment stenosis score), respectively. We assessed major adverse cardiovascular events (MACE) - inclusive of mortality, nonfatal myocardial infarction (MI), and late target vessel revascularization ≥90 days (REV)- and evaluated the incremental utility of CCTA for risk prediction, discrimination and reclassification.

Original languageEnglish
Pages (from-to)298-304
Number of pages7
JournalAtherosclerosis
Volume232
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Min, J. K., Labounty, T. M., Gomez, M. J., Achenbach, S., Al-Mallah, M., Budoff, M. J., Cademartiri, F., Callister, T. Q., Chang, H. J., Cheng, V., Chinnaiyan, K. M., Chow, B., Cury, R., Delago, A., Dunning, A., Feuchtner, G., Hadamitzky, M., Hausleiter, J., Kaufmann, P., ... Berman, D. S. (2014). Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals. Atherosclerosis, 232(2), 298-304. https://doi.org/10.1016/j.atherosclerosis.2013.09.025