Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: A 6-year follow-up from the prospective multicentre international CONFIRM study

Iksung Cho, Subhi J. Al'aref, Adam Berger, Bríain Ó Hartaigh, Heidi Gransar, Valentina Valenti, Fay Y. Lin, Stephan Achenbach, Daniel S. Berman, Matthew J. Budoff, Tracy Q. Callister, Mouaz H. Al-Mallah, Filippo Cademartiri, Kavitha Chinnaiyan, Benjamin J.W. Chow, Augustin Delago, Todd C. Villines, Martin Hadamitzky, Joerg Hausleiter, Jonathon LeipsicLeslee J. Shaw, Philipp A. Kaufmann, Gudrun Feuchtner, Yong Jin Kim, Erica Maffei, Gilbert Raff, Gianluca Pontone, Daniele Andreini, Hugo Marques, Ronen Rubinshtein, Hyuk Jae Chang, James K. Min

Research output: Contribution to journalArticle

22 Citations (Scopus)

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 languageEnglish
Pages (from-to)934-941
Number of pages8
JournalEuropean heart journal
Volume39
Issue number11
DOIs
Publication statusPublished - 2018 Mar 14

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Angiography
Coronary Vessels
Coronary Stenosis
Calcium
Coronary Artery Disease
Mortality
Coronary Angiography
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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. / Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals : A 6-year follow-up from the prospective multicentre international CONFIRM study. In: European heart journal. 2018 ; Vol. 39, No. 11. pp. 934-941.
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title = "Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: A 6-year follow-up from the prospective multicentre international CONFIRM study",
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.",
author = "Iksung Cho and Al'aref, {Subhi J.} and Adam Berger and {{\'O} Hartaigh}, Br{\'i}ain and Heidi Gransar and Valentina Valenti and Lin, {Fay Y.} and Stephan Achenbach and Berman, {Daniel S.} and Budoff, {Matthew J.} and Callister, {Tracy Q.} and Al-Mallah, {Mouaz H.} and Filippo Cademartiri and Kavitha Chinnaiyan and Chow, {Benjamin J.W.} and Augustin Delago and Villines, {Todd C.} and Martin Hadamitzky and Joerg Hausleiter and Jonathon Leipsic and Shaw, {Leslee J.} and Kaufmann, {Philipp A.} and Gudrun Feuchtner and Kim, {Yong Jin} and Erica Maffei and Gilbert Raff and Gianluca Pontone and Daniele Andreini and Hugo Marques and Ronen Rubinshtein and Chang, {Hyuk Jae} and Min, {James K.}",
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doi = "10.1093/eurheartj/ehx774",
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pages = "934--941",
journal = "European Heart Journal",
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Cho, I, Al'aref, SJ, Berger, A, Ó Hartaigh, B, Gransar, H, Valenti, V, Lin, FY, Achenbach, S, Berman, DS, Budoff, MJ, Callister, TQ, Al-Mallah, MH, Cademartiri, F, Chinnaiyan, K, Chow, BJW, Delago, A, Villines, TC, Hadamitzky, M, Hausleiter, J, Leipsic, J, Shaw, LJ, Kaufmann, PA, Feuchtner, G, Kim, YJ, Maffei, E, Raff, G, Pontone, G, Andreini, D, Marques, H, Rubinshtein, R, Chang, HJ & Min, JK 2018, 'Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: A 6-year follow-up from the prospective multicentre international CONFIRM study', European heart journal, vol. 39, no. 11, pp. 934-941. https://doi.org/10.1093/eurheartj/ehx774

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 journalArticle

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

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JO - European Heart Journal

JF - European Heart Journal

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