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, Pontone G, Mushtaq S, Gransar H, Conte E, Bartorelli AL, Pepi M, Opolski MP, Hartaigh BO, Berman DS, Budoff MJ, Achenbach S, Al-Mallah M, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJW, Cury R, Delago A, Hadamitzky M, Hausleiter J, Feuchtner G, Kim YJ, Kaufmann PA, Leipsic J, Lin FY, Maffei E, Raff G, Shaw LJ, Villines TC, Dunning A, Marques H, Rubinshtein R, Hindoyan N, Gomez M, Min JK (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 231

Pages Range: 18-25

DOI: 10.1016/j.ijcard.2016.12.137

Abstract

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.

Authors with CRIS profile

Involved external institutions

Università degli studi di Milano Italy (IT) Institute of Cardiology in Warsaw Poland (PL) New York Presbyterian Hospital United States (USA) (US) Cedars-Sinai Medical Center United States (USA) (US) Harbor–UCLA Medical Center United States (USA) (US) King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) / جامعة الملك سعود بن عبد العزيز للعلوم الصحية Saudi Arabia (SA) Erasmus University Medical Center (MC) Netherlands (NL) Tennessee Heart & Vascular United States (USA) (US) Yonsei University Health System (YUHS) Korea, Republic of (KR) Beaumont Health System United States (USA) (US) University of Ottawa Canada (CA) Baptist Health South Florida United States (USA) (US) Capitol Cardiology Associates United States (USA) (US) Deutsches Herzzentrum München Germany (DE) Ludwig-Maximilians-Universität (LMU) Germany (DE) Medizinische Universität Innsbruck Austria (AT) Seoul National University (SNU) / 서울대학교 Korea, Republic of (KR) Universitätsspital Zürich (USZ) Switzerland (CH) University of British Columbia Canada (CA) Casa di Cura Giovanni XXIII Italy (IT) Emory University United States (USA) (US) Walter Reed Army Medical Center (WRAMC) United States (USA) (US) Cornell University United States (USA) (US) Hospital Curry Cabral Portugal (PT) Technion - Israel Institute of Technology Israel (IL)

How to cite

APA:

Andreini, D., Pontone, G., Mushtaq, S., Gransar, H., Conte, E., Bartorelli, A.L.,... Min, J.K. (2017). 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. International Journal of Cardiology, 231, 18-25. https://doi.org/10.1016/j.ijcard.2016.12.137

MLA:

Andreini, Daniele, et al. "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." International Journal of Cardiology 231 (2017): 18-25.

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