We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age.
- Authors
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
- 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.
- Subjects
ATHEROSCLEROSIS; CORONARY disease; COMPUTED tomography; CORONARY angiography; PROGNOSIS
- Publication
Heart & Vessels, 2018, Vol 33, Issue 11, p1288
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-018-1188-3