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.
N1 - Funding Information:
This work is supported by the National Heart, Lung and Blood Institute under award number (R01HL115150 and R01HL118019) and also in part by a generous gift from the Dalio Institute of Cardiovascular Imaging (New York, NY) and the Michael Wolk Foundation. This study was also funded by an unrestricted educational grant from GE Healthcare.
Publisher Copyright:
© 2017 The Author.
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 -