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 D Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy. Electronic address: daniele.andreini@ccfm.it.
- Pontone G Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Mushtaq S Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Gransar H Department of Imaging and Division of Cardiology, Department of Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Conte E Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Bartorelli AL Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Pepi M Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Opolski MP Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
- Ó Hartaigh B Department of Radiology, The New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
- Berman DS Department of Imaging and Division of Cardiology, Department of Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Budoff MJ Department of Medicine, Harbor UCLA Medical Center, Los Angeles, CA, USA.
- Achenbach S Department of Medicine, University of Erlangen, Erlangen, Germany.
- Al-Mallah M King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdul Aziz Cardiac Center, Ministry of National Guard, Health Affairs, Saudi Arabia.
- Cademartiri F Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Cardiovascular Imaging Unit, Giovanni XXIII Hospital, Monastier, Italy.
- Callister TQ Tennessee Heart and Vascular Institute, Hendersonville, TN, USA.
- Chang HJ Division of Cardiology, Severance Cardiovascular Hospital, Seoul, South Korea.
- Chinnaiyan K William Beaumont Hospital, Royal Oaks, MI, USA.
- Chow BJ Department of Medicine and Radiology, University of Ottawa Heart Institute, Ontario, Canada.
- Cury R Baptist Cardiac and Vascular Institute, Miami, FL, USA.
- Delago A Capitol Cardiology Associates, Albany, NY, USA.
- Hadamitzky M Division of Cardiology, Deutsches Herzzentrum München, Munich, Germany.
- Hausleiter J Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany.
- Feuchtner G Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
- Kim YJ Department of Medicine and Radiology, Seoul National University Hospital, Seoul, South Korea.
- Kaufmann PA Department of Nuclear Cardiology, Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland.
- Leipsic J Department of Medical Imaging and Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
- Lin FY Department of Radiology, The New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
- Maffei E Cardiovascular Imaging Unit, Giovanni XXIII Hospital, Monastier, Italy.
- Raff G William Beaumont Hospital, Royal Oaks, MI, USA.
- Shaw LJ Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
- Villines TC Department of Medicine, Walter Reed National Medical Center, Bethesda, MD, USA.
- Dunning A Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Marques H Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
- Rubinshtein R Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
- Hindoyan N Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, NY, USA.
- Gomez M Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, NY, USA.
- Min JK Department of Radiology, The New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
- 2017-01-14
Published in:
- International journal of cardiology. - 2017
CT-adapted Leaman score
Coronary CT angiography
Non-obstructive CAD
Patients reclassification
Prognosis
Aged
Cause of Death
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Female
Follow-Up Studies
Global Health
Humans
Male
Predictive Value of Tests
Prognosis
Prospective Studies
Registries
Risk Assessment
Risk Factors
Time Factors
English
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.
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.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.ijcard.2016.12.137
- PMID 28082093
- Persistent URL
- https://sonar.ch/global/documents/47410
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