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Title:

Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age.

Document type:
Article; Journal Article; Multicenter Study; Observational Study
Author(s):
Ayoub, Chadi; Kritharides, Leonard; Yam, Yeung; Chen, Li; Hossain, Alomgir; Achenbach, Stephan; Al-Mallah, Mouaz H; Andreini, Daniele; Berman, Daniel S; Budoff, Matthew J; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Cury, Ricardo C; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Gomez, Millie; Gransar, Heidi; Hadamitzky, Martin; Hausleiter, Joerg; Hindoyan, Niree; Kaufmann, Philipp A; Kim, Yong-Jin; Leipsic, Jonathon; Maffei, Erica; Marques, Hugo; Pont...     »
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 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (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.
Journal title abbreviation:
Heart Vessels
Year:
2018
Journal volume:
33
Journal issue:
11
Pages contribution:
1288-1300
Language:
eng
Fulltext / DOI:
doi:10.1007/s00380-018-1188-3
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/29797058
Print-ISSN:
0910-8327
TUM Institution:
Institut für Radiologie
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