Abstract
BACKGROUND: Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD).
METHODS: From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (<50% stenosis). Segment-involvement score (SIS) and CT-LeSc were calculated. Outcomes were non-fatal myocardial infarction (MI) and the combined end-point of MI and all-cause mortality.
RESULTS: Patient mean age was 56±12years. At follow-up (mean 59.8±13.9months), 183 events occurred (53 MI, 99 all-cause deaths and 31 late revascularizations). CT-LeSc was the only multivariate predictor of MI (HRs 2.84 and 2.98 in two models with Framingham and risk factors, respectively) and of MI plus all-cause mortality (HR 2.48 and 1.94 in two models with Framingham and risk factors, respectively). This was confirmed by a net reclassification analysis confirming that the CT-LeSc was able to correctly reclassify a significant proportion of patients (cNRI 0.28 and 0.23 for MI and MI plus all-cause mortality, respectively) vs. baseline model, whereas SIS did not.
CONCLUSION: CT-LeSc is an independent predictor of major acute cardiac events, improving prognostic stratification of patients with non-obstructive CAD.
| Original language | English |
|---|---|
| Pages (from-to) | 18-25 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 231 |
| DOIs | |
| Publication status | Published - Mar 15 2017 |
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Keywords
- Journal Article
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Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD : Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) study. / Andreini, Daniele; Pontone, Gianluca; Mushtaq, Saima; Gransar, Heidi; Conte, Edoardo; Bartorelli, Antonio L; Pepi, Mauro; Opolski, Maksymilian P.; Ó Hartaigh, Bríain; Berman, Daniel S.; Budoff, Matthew J.; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; Cury, Ricardo C.; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Feuchtner, Gudrun; Kim, Yong Jin; Kaufmann, Philipp A.; Leipsic, Jonathon; Lin, Fay Y.; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J.; Villines, Todd C.; Dunning, Allison; Marques, Hugo; Rubinshtein, Ronen; Hindoyan, Niree; Gomez, Millie J.; Min, James K.
In: International Journal of Cardiology, Vol. 231, 15.03.2017, p. 18-25.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD
T2 - Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) study
AU - Andreini, Daniele
AU - Pontone, Gianluca
AU - Mushtaq, Saima
AU - Gransar, Heidi
AU - Conte, Edoardo
AU - Bartorelli, Antonio L
AU - Pepi, Mauro
AU - Opolski, Maksymilian P.
AU - Ó Hartaigh, Bríain
AU - Berman, Daniel S.
AU - Budoff, Matthew J.
AU - Achenbach, Stephan
AU - Al-Mallah, Mouaz
AU - Cademartiri, Filippo
AU - Callister, Tracy Q.
AU - Chang, Hyuk Jae
AU - Chinnaiyan, Kavitha
AU - Chow, Benjamin J W
AU - Cury, Ricardo C.
AU - DeLago, Augustin
AU - Hadamitzky, Martin
AU - Hausleiter, Joerg
AU - Feuchtner, Gudrun
AU - Kim, Yong Jin
AU - Kaufmann, Philipp A.
AU - Leipsic, Jonathon
AU - Lin, Fay Y.
AU - Maffei, Erica
AU - Raff, Gilbert
AU - Shaw, Leslee J.
AU - Villines, Todd C.
AU - Dunning, Allison
AU - Marques, Hugo
AU - Rubinshtein, Ronen
AU - Hindoyan, Niree
AU - Gomez, Millie J.
AU - Min, James K.
N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
PY - 2017/3/15
Y1 - 2017/3/15
N2 - BACKGROUND: Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD).METHODS: From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (<50% stenosis). Segment-involvement score (SIS) and CT-LeSc were calculated. Outcomes were non-fatal myocardial infarction (MI) and the combined end-point of MI and all-cause mortality.RESULTS: Patient mean age was 56±12years. At follow-up (mean 59.8±13.9months), 183 events occurred (53 MI, 99 all-cause deaths and 31 late revascularizations). CT-LeSc was the only multivariate predictor of MI (HRs 2.84 and 2.98 in two models with Framingham and risk factors, respectively) and of MI plus all-cause mortality (HR 2.48 and 1.94 in two models with Framingham and risk factors, respectively). This was confirmed by a net reclassification analysis confirming that the CT-LeSc was able to correctly reclassify a significant proportion of patients (cNRI 0.28 and 0.23 for MI and MI plus all-cause mortality, respectively) vs. baseline model, whereas SIS did not.CONCLUSION: CT-LeSc is an independent predictor of major acute cardiac events, improving prognostic stratification of patients with non-obstructive CAD.
AB - BACKGROUND: Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD).METHODS: From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (<50% stenosis). Segment-involvement score (SIS) and CT-LeSc were calculated. Outcomes were non-fatal myocardial infarction (MI) and the combined end-point of MI and all-cause mortality.RESULTS: Patient mean age was 56±12years. At follow-up (mean 59.8±13.9months), 183 events occurred (53 MI, 99 all-cause deaths and 31 late revascularizations). CT-LeSc was the only multivariate predictor of MI (HRs 2.84 and 2.98 in two models with Framingham and risk factors, respectively) and of MI plus all-cause mortality (HR 2.48 and 1.94 in two models with Framingham and risk factors, respectively). This was confirmed by a net reclassification analysis confirming that the CT-LeSc was able to correctly reclassify a significant proportion of patients (cNRI 0.28 and 0.23 for MI and MI plus all-cause mortality, respectively) vs. baseline model, whereas SIS did not.CONCLUSION: CT-LeSc is an independent predictor of major acute cardiac events, improving prognostic stratification of patients with non-obstructive CAD.
KW - Journal Article
U2 - 10.1016/j.ijcard.2016.12.137
DO - 10.1016/j.ijcard.2016.12.137
M3 - Article
VL - 231
SP - 18
EP - 25
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -