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24.05.2018 | Original Article

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

verfasst von: 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

Erschienen in: Heart and Vessels | Ausgabe 11/2018

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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.
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Metadaten
Titel
Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age
verfasst von
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
Publikationsdatum
24.05.2018
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 11/2018
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1188-3

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