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

Chadi Ayoub; Leonard Kritharides; Yeung Yam; Li Chen; Alomgir Hossain; Stephan Achenbach; Mouaz H. Al-Mallah; Daniele Andreini; Daniel S. Berman; Matthew J. Budoff; Filippo Cademartiri; Tracy Q. Callister; Hyuk Jae Chang; Kavitha Chinnaiyan; Ricardo C. Cury; Augustin Delago; Allison Dunning; Gudrun Feuchtner; Millie Gomez; Heidi Gransar; Martin Hadamitzky; Joerg Hausleiter; Niree Hindoyan; Philipp A. Kaufmann; Yong Jin Kim; Jonathon Leipsic; Erica Maffei; Hugo Marques; Gianluca Pontone; Gilbert Raff; Ronen Rubinshtein; Leslee J. Shaw; Todd C. Villines; James K. Min; Benjamin J.W. Chow

doi:10.1007/s00380-018-1188-3

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

Chadi Ayoub, Leonard Kritharides, Yeung Yam, Li Chen, Alomgir Hossain, Stephan Achenbach, Mouaz H. Al-Mallah, Daniele Andreini, Daniel S. Berman, Matthew J. Budoff, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Kavitha Chinnaiyan, Ricardo C. Cury, Augustin Delago, Allison Dunning, Gudrun Feuchtner, Millie Gomez, Heidi GransarMartin Hadamitzky, Joerg Hausleiter, Niree Hindoyan, Philipp A. Kaufmann, Yong Jin Kim, Jonathon Leipsic, Erica Maffei, Hugo Marques, Gianluca Pontone, Gilbert Raff, Ronen Rubinshtein, Leslee J. Shaw, Todd C. Villines, James K. Min, Benjamin J.W. Chow

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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.

Original language	English
Pages (from-to)	1288-1300
Number of pages	13
Journal	Heart and Vessels
Volume	33
Issue number	11
DOIs	https://doi.org/10.1007/s00380-018-1188-3
State	Published - Nov 2018

Keywords

Atherosclerosis
Computed tomography
Coronary
Prognosis

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10.1007/s00380-018-1188-3

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Ayoub, C., Kritharides, L., Yam, Y., Chen, L., Hossain, A., Achenbach, S., Al-Mallah, M. H., Andreini, D., Berman, D. S., Budoff, M. J., Cademartiri, F., Callister, T. Q., Chang, H. J., Chinnaiyan, K., Cury, R. C., Delago, A., Dunning, A., Feuchtner, G., Gomez, M., ... Chow, B. J. W. (2018). Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age. Heart and Vessels, 33(11), 1288-1300. https://doi.org/10.1007/s00380-018-1188-3

@article{c84f511e22204c72a65b4e4ac73a150a,

title = "Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age",

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 {\textquoteleft}age adjusted SIS{\textquoteright} (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.",

keywords = "Atherosclerosis, Computed tomography, Coronary, Prognosis",

author = "Chadi Ayoub and Leonard Kritharides and Yeung Yam and Li Chen and Alomgir Hossain and Stephan Achenbach and Al-Mallah, {Mouaz H.} and Daniele Andreini and Berman, {Daniel S.} and Budoff, {Matthew J.} and Filippo Cademartiri and Callister, {Tracy Q.} and Chang, {Hyuk Jae} and Kavitha Chinnaiyan and Cury, {Ricardo C.} and Augustin Delago and Allison Dunning and Gudrun Feuchtner and Millie Gomez and Heidi Gransar and Martin Hadamitzky and Joerg Hausleiter and Niree Hindoyan and Kaufmann, {Philipp A.} and Kim, {Yong Jin} and Jonathon Leipsic and Erica Maffei and Hugo Marques and Gianluca Pontone and Gilbert Raff and Ronen Rubinshtein and Shaw, {Leslee J.} and Villines, {Todd C.} and Min, {James K.} and Chow, {Benjamin J.W.}",

note = "Publisher Copyright: {\textcopyright} Springer Japan KK, part of Springer Nature 2018.",

year = "2018",

month = nov,

doi = "10.1007/s00380-018-1188-3",

language = "English",

volume = "33",

pages = "1288--1300",

journal = "Heart and Vessels",

issn = "0910-8327",

publisher = "Springer Japan",

number = "11",

}

Ayoub, C, Kritharides, L, Yam, Y, Chen, L, Hossain, A, Achenbach, S, Al-Mallah, MH, Andreini, D, Berman, DS, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Chinnaiyan, K, Cury, RC, Delago, A, Dunning, A, Feuchtner, G, Gomez, M, Gransar, H, Hadamitzky, M, Hausleiter, J, Hindoyan, N, Kaufmann, PA, Kim, YJ, Leipsic, J, Maffei, E, Marques, H, Pontone, G, Raff, G, Rubinshtein, R, Shaw, LJ, Villines, TC, Min, JK & Chow, BJW 2018, 'Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age', Heart and Vessels, vol. 33, no. 11, pp. 1288-1300. https://doi.org/10.1007/s00380-018-1188-3

TY - JOUR

T1 - Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography

T2 - a potential marker of vascular age

AU - Ayoub, Chadi

AU - Kritharides, Leonard

AU - Yam, Yeung

AU - Chen, Li

AU - Hossain, Alomgir

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz H.

AU - Andreini, Daniele

AU - Berman, Daniel S.

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Chinnaiyan, Kavitha

AU - Cury, Ricardo C.

AU - Delago, Augustin

AU - Dunning, Allison

AU - Feuchtner, Gudrun

AU - Gomez, Millie

AU - Gransar, Heidi

AU - Hadamitzky, Martin

AU - Hausleiter, Joerg

AU - Hindoyan, Niree

AU - Kaufmann, Philipp A.

AU - Kim, Yong Jin

AU - Leipsic, Jonathon

AU - Maffei, Erica

AU - Marques, Hugo

AU - Pontone, Gianluca

AU - Raff, Gilbert

AU - Rubinshtein, Ronen

AU - Shaw, Leslee J.

AU - Villines, Todd C.

AU - Min, James K.

AU - Chow, Benjamin J.W.

PY - 2018/11

Y1 - 2018/11

N2 - 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.

AB - 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.

KW - Atherosclerosis

KW - Computed tomography

KW - Coronary

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85047359626&partnerID=8YFLogxK

U2 - 10.1007/s00380-018-1188-3

DO - 10.1007/s00380-018-1188-3

M3 - Article

C2 - 29797058

AN - SCOPUS:85047359626

SN - 0910-8327

VL - 33

SP - 1288

EP - 1300

JO - Heart and Vessels

JF - Heart and Vessels

IS - 11

ER -

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

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Keywords

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