Long term prognostic utility of coronary CT angiography in patients with no modifiable coronary artery disease risk factors: Results from the 5 year follow-up of the CONFIRM International Multicenter Registry

Cheruvu C, Precious B, Naoum C, Blanke P, Ahmadi A, Soon J, Arepalli C, Gransar H, Achenbach S, Berman DS, Budoff MJ, Callister TQ, Al-Mallah MH, Cademartiri F, Chinnaiyan K, Rubinshtein R, Marquez H, Delago A, Villines TC, Hadamitzky M, Hausleiter J, Shaw LJ, Kaufmann PA, Cury RC, Feuchtner G, Kim YJ, Maffei E, Raff G, Pontone G, Andreini D, Chang HJ, Min JK, Leipsic J (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Book Volume: 10

Pages Range: 22-7

Journal Issue: 1

DOI: 10.1016/j.jcct.2015.12.005

Abstract

Coronary computed tomography angiography (coronary CTA) can prognosticate outcomes in patients without modifiable risk factors over medium term follow-up. This ability was driven by major adverse cardiovascular events (MACE).Determine if coronary CTA could discriminate risk of mortality with longer term follow-up. In addition we sought to determine the long-term relationship to MACE.From 12 centers, 1884 patients undergoing coronary CTA without prior coronary artery disease (CAD) or any modifiable CAD risk factors were identified. The presence of CAD was classified as none (0% stenosis), mild (1% to 49% stenosis) and obstructive (>=50% stenosis severity). The primary endpoint was all-cause mortality and the secondary endpoint was MACE. MACE was defined as the combination of death, nonfatal myocardial infarction, unstable angina, and late target vessel revascularization (>90 days).Mean age was 55.6 ± 14.5 years. At mean 5.6 ± 1.3 years follow-up, 145(7.7%) deaths occurred. All-cause mortality demonstrated a dose-response relationship to the severity and number of coronary vessels exhibiting CAD. Increased mortality was observed for >1 segment non-obstructive CAD (hazard ratio [HR]:1.73; 95% confidence interval [CI]: 1.07-2.79; p = 0.025), obstructive 1&2 vessel CAD (HR: 1.70; 95% CI: 1.08-2.71; p = 0.023) and 3-vessel or left main CAD (HR: 2.87; 95% CI: 1.57-5.23; p = 0.001). Both obstructive CAD (HR: 6.63; 95% CI: 3.91-11.26; p < 0.001) and non-obstructive CAD (HR: 2.20; 95% CI: 1.31-3.67; p = 0.003) predicted MACE with increased hazard associated with increasing CAD severity; 5.60% in no CAD, 13.24% in non-obstructive and 36.28% in obstructive CAD, p < 0.001 for trend.In individuals being assessed for CAD with no modifiable risk factors, all-cause mortality in the long term (>5 years) was predicted by the presence of more than 1 segment of non-obstructive plaque, obstructive 1- or 2-vessel CAD and 3 vessel/left main CAD. Any CAD, whether non-obstructive or obstructive, predicted MACE over the same time period.

Authors with CRIS profile

Involved external institutions

University of British Columbia Canada (CA) Ludwig-Maximilians-Universität (LMU) Germany (DE) New York Presbyterian Hospital United States (USA) (US) University of California Los Angeles (UCLA) United States (USA) (US) Cedars-Sinai Medical Center United States (USA) (US) Harbor–UCLA Medical Center United States (USA) (US) Tennessee Heart & Vascular United States (USA) (US) Wayne State University (WSU) United States (USA) (US) Casa di Cura Giovanni XXIII Italy (IT) Beaumont Health System United States (USA) (US) Technion - Israel Institute of Technology Israel (IL) Capitol Cardiology Associates United States (USA) (US) Walter Reed Army Medical Center (WRAMC) United States (USA) (US) Deutsches Herzzentrum München Germany (DE) Emory University United States (USA) (US) Universitätsspital Zürich (USZ) Switzerland (CH) Baptist Health South Florida United States (USA) (US) Medizinische Universität Innsbruck Austria (AT) Seoul National University (SNU) / 서울대학교 Korea, Republic of (KR) Università degli studi di Milano Italy (IT) Yonsei University Health System (YUHS) Korea, Republic of (KR)

How to cite

APA:

Cheruvu, C., Precious, B., Naoum, C., Blanke, P., Ahmadi, A., Soon, J.,... Leipsic, J. (2016). Long term prognostic utility of coronary CT angiography in patients with no modifiable coronary artery disease risk factors: Results from the 5 year follow-up of the CONFIRM International Multicenter Registry. Journal of Cardiovascular Computed Tomography, 10(1), 22-7. https://doi.org/10.1016/j.jcct.2015.12.005

MLA:

Cheruvu, Chaitu, et al. "Long term prognostic utility of coronary CT angiography in patients with no modifiable coronary artery disease risk factors: Results from the 5 year follow-up of the CONFIRM International Multicenter Registry." Journal of Cardiovascular Computed Tomography 10.1 (2016): 22-7.

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