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

Ayoub C, Kritharides L, Yam Y, Chen L, Hossain A, Achenbach S, Al-Mallah MH, Andreini D, Berman DS, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Cury RC, Delago A, Dunning A, Feuchtner G, Gomez M, Gransar H, Hadamitzky M, Hausleiter J, Hindoyan N, Kaufmann PA, Kim YJ, Leipsic J, Maffei E, Marques H, Pontone G, Raff G, Rubinshtein R, Shaw LJ, Villines TC, Min JK, Chow BJW (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Book Volume: 33

Pages Range: 1288-1300

Journal Issue: 11

DOI: 10.1007/s00380-018-1188-3

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.

Authors with CRIS profile

Involved external institutions

Walter Reed Army Medical Center (WRAMC) United States (USA) (US) University of Sydney (USYD) Australia (AU) Università degli studi di Milano Italy (IT) Cedars-Sinai Medical Center United States (USA) (US) Duke University Medical Center United States (USA) (US) Tennessee Heart & Vascular United States (USA) (US) Cornell University United States (USA) (US) University of British Columbia Canada (CA) Casa di Cura Giovanni XXIII Italy (IT) Beaumont Health System United States (USA) (US) King Abdulaziz Cardiac Center Saudi Arabia (SA) University of Ottawa Canada (CA) Yonsei University Korea, Republic of (KR) Medizinische Universität Innsbruck Austria (AT) Technion - Israel Institute of Technology Israel (IL) Hospital Curry Cabral Portugal (PT) Harbor–UCLA Medical Center United States (USA) (US) Capitol Cardiology Associates United States (USA) (US) Seoul National University (SNU) / 서울대학교 Korea, Republic of (KR) Universitätsspital Zürich (USZ) Switzerland (CH) Baptist Health South Florida United States (USA) (US) Deutsches Herzzentrum München Germany (DE) Emory University United States (USA) (US)

How to cite

APA:

Ayoub, C., Kritharides, L., Yam, Y., Chen, L., Hossain, A., Achenbach, S.,... Chow, B.J.W. (2018). Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age. Heart and Vessels, 33(11), 1288-1300. https://doi.org/10.1007/s00380-018-1188-3

MLA:

Ayoub, Chadi, et al. "Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age." Heart and Vessels 33.11 (2018): 1288-1300.

BibTeX: Download