Abstract
Aim The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. Methods and results From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental v2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Conclusions Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.
| Original language | English |
|---|---|
| Pages (from-to) | 934-941 |
| Number of pages | 8 |
| Journal | European heart journal |
| Volume | 39 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2018 Mar 14 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals : A 6-year follow-up from the prospective multicentre international CONFIRM study. / Cho, Iksung; Al'aref, Subhi J.; Berger, Adam; Ó Hartaigh, Bríain; Gransar, Heidi; Valenti, Valentina; Lin, Fay Y.; Achenbach, Stephan; Berman, Daniel S.; Budoff, Matthew J.; Callister, Tracy Q.; Al-Mallah, Mouaz H.; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J.W.; Delago, Augustin; Villines, Todd C.; Hadamitzky, Martin; Hausleiter, Joerg; Leipsic, Jonathon; Shaw, Leslee J.; Kaufmann, Philipp A.; Feuchtner, Gudrun; Kim, Yong Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Marques, Hugo; Rubinshtein, Ronen; Chang, Hyuk Jae; Min, James K.
In: European heart journal, Vol. 39, No. 11, 14.03.2018, p. 934-941.Research output: Contribution to journal › Article
TY - JOUR
T1 - Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals
T2 - A 6-year follow-up from the prospective multicentre international CONFIRM study
AU - Cho, Iksung
AU - Al'aref, Subhi J.
AU - Berger, Adam
AU - Ó Hartaigh, Bríain
AU - Gransar, Heidi
AU - Valenti, Valentina
AU - Lin, Fay Y.
AU - Achenbach, Stephan
AU - Berman, Daniel S.
AU - Budoff, Matthew J.
AU - Callister, Tracy Q.
AU - Al-Mallah, Mouaz H.
AU - Cademartiri, Filippo
AU - Chinnaiyan, Kavitha
AU - Chow, Benjamin J.W.
AU - Delago, Augustin
AU - Villines, Todd C.
AU - Hadamitzky, Martin
AU - Hausleiter, Joerg
AU - Leipsic, Jonathon
AU - Shaw, Leslee J.
AU - Kaufmann, Philipp A.
AU - Feuchtner, Gudrun
AU - Kim, Yong Jin
AU - Maffei, Erica
AU - Raff, Gilbert
AU - Pontone, Gianluca
AU - Andreini, Daniele
AU - Marques, Hugo
AU - Rubinshtein, Ronen
AU - Chang, Hyuk Jae
AU - Min, James K.
PY - 2018/3/14
Y1 - 2018/3/14
N2 - Aim The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. Methods and results From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental v2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Conclusions Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.
AB - Aim The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. Methods and results From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental v2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Conclusions Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.
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U2 - 10.1093/eurheartj/ehx774
DO - 10.1093/eurheartj/ehx774
M3 - Article
C2 - 29365193
AN - SCOPUS:85044267369
VL - 39
SP - 934
EP - 941
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 11
ER -