TY - JOUR
T1 - Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography
T2 - a potential marker of vascular age
AU - Ayoub, Chadi
AU - Kritharides, Leonard
AU - Yam, Yeung
AU - Chen, Li
AU - Hossain, Alomgir
AU - Achenbach, Stephan
AU - Al-Mallah, Mouaz H.
AU - Andreini, Daniele
AU - Berman, Daniel S.
AU - Budoff, Matthew J.
AU - Cademartiri, Filippo
AU - Callister, Tracy Q.
AU - Chang, Hyuk Jae
AU - Chinnaiyan, Kavitha
AU - Cury, Ricardo C.
AU - Delago, Augustin
AU - Dunning, Allison
AU - Feuchtner, Gudrun
AU - Gomez, Millie
AU - Gransar, Heidi
AU - Hadamitzky, Martin
AU - Hausleiter, Joerg
AU - Hindoyan, Niree
AU - Kaufmann, Philipp A.
AU - Kim, Yong Jin
AU - Leipsic, Jonathon
AU - Maffei, Erica
AU - Marques, Hugo
AU - Pontone, Gianluca
AU - Raff, Gilbert
AU - Rubinshtein, Ronen
AU - Shaw, Leslee J.
AU - Villines, Todd C.
AU - Min, James K.
AU - Chow, Benjamin J.W.
N1 - Funding Information:
The assistance of the Mayo Clinic Medical illustrations Unit with the figures is acknowledged with much thanks. Benjamin Chow receives research support from CV Diagnostix, and research and educational support from TeraRecon Inc. and holds the Saul & Edna Goldfarb Research Chair in Cardiac Imaging. There is no funding associated with this work.
Publisher Copyright:
© Springer Japan KK, part of Springer Nature 2018.
PY - 2018/11
Y1 - 2018/11
N2 - Extent of coronary atherosclerotic disease (CAD) burden on coronary computed tomography angiography (CCTA) as measured by segment involvement score (SIS) has a prognostic value. We sought to investigate the incremental prognostic value of ‘age adjusted SIS’ (aSIS), which may be a marker of premature atherosclerosis and vascular age. Consecutive patients were prospectively enrolled into the CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicentre) multinational observational study. Patients were followed for the outcome of all-cause death. aSIS was calculated on CCTA for each patient, and its incremental prognostic value was evaluated. A total of 22,211 patients [mean age 58.5 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (IQR 17.8, 35.4)] were identified. After adjustment for clinical factors and presence of obstructive CAD, higher aSIS was associated with increased death on multivariable analysis, with hazard ratio (HR) 2.40 (1.83–3.16, p < 0.001), C-statistic 0.723 (0.700–0.756), net reclassification improvement (NRI) 0.36 (0.26–0.47, p < 0.001), and relative integrated discrimination improvement (IDI) 0.33 (p = 0.009). aSIS had HR 3.48 (2.33–5.18, p < 0.001) for mortality in those without obstructive CAD, compared to HR 1.79 (1.25–2.58, p = 0.02) in those with obstructive CAD. In conclusion, aSIS has an incremental prognostic value to traditional risk factors and obstructive CAD, and may enhance CCTA risk stratification.
AB - Extent of coronary atherosclerotic disease (CAD) burden on coronary computed tomography angiography (CCTA) as measured by segment involvement score (SIS) has a prognostic value. We sought to investigate the incremental prognostic value of ‘age adjusted SIS’ (aSIS), which may be a marker of premature atherosclerosis and vascular age. Consecutive patients were prospectively enrolled into the CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicentre) multinational observational study. Patients were followed for the outcome of all-cause death. aSIS was calculated on CCTA for each patient, and its incremental prognostic value was evaluated. A total of 22,211 patients [mean age 58.5 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (IQR 17.8, 35.4)] were identified. After adjustment for clinical factors and presence of obstructive CAD, higher aSIS was associated with increased death on multivariable analysis, with hazard ratio (HR) 2.40 (1.83–3.16, p < 0.001), C-statistic 0.723 (0.700–0.756), net reclassification improvement (NRI) 0.36 (0.26–0.47, p < 0.001), and relative integrated discrimination improvement (IDI) 0.33 (p = 0.009). aSIS had HR 3.48 (2.33–5.18, p < 0.001) for mortality in those without obstructive CAD, compared to HR 1.79 (1.25–2.58, p = 0.02) in those with obstructive CAD. In conclusion, aSIS has an incremental prognostic value to traditional risk factors and obstructive CAD, and may enhance CCTA risk stratification.
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U2 - 10.1007/s00380-018-1188-3
DO - 10.1007/s00380-018-1188-3
M3 - Article
C2 - 29797058
AN - SCOPUS:85047359626
VL - 33
SP - 1288
EP - 1300
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 11
ER -