Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age
Articolo
Data di Pubblicazione:
2018
Citazione:
Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age / C. Ayoub, L. Kritharides, Y. Yam, L. Chen, A. Hossain, S. Achenbach, M.H. Al-Mallah, D. Andreini, D.S. Berman, M.J. Budoff, F. Cademartiri, T.Q. Callister, H. Chang, K. Chinnaiyan, R.C. Cury, A. Delago, A. Dunning, G. Feuchtner, M. Gomez, H. Gransar, M. Hadamitzky, J. Hausleiter, N. Hindoyan, P.A. Kaufmann, Y. Kim, J. Leipsic, E. Maffei, H. Marques, G. Pontone, G. Raff, R. Rubinshtein, L.J. Shaw, T.C. Villines, J.K. Min, B.J.W. Chow. - In: HEART AND VESSELS. - ISSN 0910-8327. - 33:11(2018 Nov), pp. 1288-1300. [10.1007/s00380-018-1188-3]
Abstract:
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 +/- 12.7years, 55.8% male) with a median follow-up of 27.3months (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.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Atherosclerosis; Computed tomography; Coronary; Prognosis
Elenco autori:
C. Ayoub, L. Kritharides, Y. Yam, L. Chen, A. Hossain, S. Achenbach, M.H. Al-Mallah, D. Andreini, D.S. Berman, M.J. Budoff, F. Cademartiri, T.Q. Callister, H. Chang, K. Chinnaiyan, R.C. Cury, A. Delago, A. Dunning, G. Feuchtner, M. Gomez, H. Gransar, M. Hadamitzky, J. Hausleiter, N. Hindoyan, P.A. Kaufmann, Y. Kim, J. Leipsic, E. Maffei, H. Marques, G. Pontone, G. Raff, R. Rubinshtein, L.J. Shaw, T.C. Villines, J.K. Min, B.J.W. Chow
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