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.
N1 - Publisher Copyright:
© Springer Japan KK, part of Springer Nature 2018.
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 - https://www.scopus.com/pages/publications/85047359626
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 -