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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

Authors
 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 ... Show more  ;  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 Leipsic  ;  Leslee 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 
Citation
 EUROPEAN HEART JOURNAL, Vol.39(11) : 934-941, 2018 
Journal Title
EUROPEAN HEART JOURNAL
ISSN
 0195-668X 
Issue Date
2018
Keywords
Coronary artery calcium scoring ; Coronary CT angiography ; Prognosis ; Coronary artery disease ; Computed tomography ; Atherosclerosis
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 χ2 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.
Full Text
https://academic.oup.com/eurheartj/article/39/11/934/4815727
DOI
10.1093/eurheartj/ehx774
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166789
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