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Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study.
Cho, Iksung; Al'Aref, Subhi J; Berger, Adam; Ó Hartaigh, Bríain; Gransar, Heidi; Valenti, Valentina; Lin, Fay Y; Achenbach, Stephan; Berman, Daniel S; Budoff, Matthew J; Callister, Tracy Q; Al-Mallah, Mouaz H; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Villines, Todd C; Hadamitzky, Martin; Hausleiter, Joerg; Leipsic, Jonathon; Shaw, Leslee J; Kaufmann, Philipp A; Feuchtner, Gudrun; Kim, Yong-Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Marques, Hugo; Rubinshtein, Ronen; Chang, Hyuk-Jae; Min, James K.
Afiliação
  • Cho I; Department of Radiology, Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital, Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY 10021, USA.
  • Al'Aref SJ; Division of Cardiology, Severance Cardiovascular Hospital, Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
  • Berger A; Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University, Seoul, South Korea.
  • Ó Hartaigh B; Department of Radiology, Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital, Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY 10021, USA.
  • Gransar H; Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
  • Valenti V; Department of Radiology, Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital, Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY 10021, USA.
  • Lin FY; Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
  • Achenbach S; Department of Radiology, Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital, Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY 10021, USA.
  • Berman DS; Department of Radiology, Dalio Institute of Cardiovascular Imaging, NewYork-Presbyterian Hospital, Weill Cornell Medical College, 413 East 69th Street, Suite 108, New York, NY 10021, USA.
  • Budoff MJ; Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
  • Callister TQ; Department of Medicine, University of Erlangen, Erlangen, Germany.
  • Al-Mallah MH; Department of Medicine, Harbor UCLA Medical Center, Los Angeles, CA, USA.
  • Cademartiri F; Tennessee Heart and Vascular Institute, Hendersonville, TN, USA.
  • Chinnaiyan K; King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King AbdulAziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia.
  • Chow BJW; Department of Radiology, Montreal Heart Institute, Montreal, Quebec, Canada.
  • DeLago A; William Beaumont Hospital, Royal Oaks, MI, USA.
  • Villines TC; Department of Medicine and Radiology, University of Ottawa, Ottawa, Ontario, Canada.
  • Hadamitzky M; Capitol Cardiology Associates, Albany, NY, USA.
  • Hausleiter J; Department of Medicine, Walter Reed Medical Center, Washington, DC, USA.
  • Leipsic J; Division of Cardiology, Deutsches Herzzentrum Munchen, Munich, Germany.
  • Shaw LJ; Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany.
  • Kaufmann PA; Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Feuchtner G; Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
  • Kim YJ; University Hospital, Zurich, Switzerland.
  • Maffei E; Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Raff G; Seoul National University Hospital, Seoul, South Korea.
  • Pontone G; Department of Radiology, Montreal Heart Institute, Montreal, Quebec, Canada.
  • Andreini D; William Beaumont Hospital, Royal Oaks, MI, USA.
  • Marques H; Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Milan, Italy.
  • Rubinshtein R; Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS Milan, Milan, Italy.
  • Chang HJ; UNICA, Cardiac CT and MRI Unit, Hospital da Luz, Lisbon, Portugal.
  • Min JK; 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.
Eur Heart J ; 39(11): 934-941, 2018 03 14.
Article em En | MEDLINE | ID: mdl-29365193
Aim: The long-term prognostic benefit of coronary computed tomographic angiography (CCTA) findings of coronary artery disease (CAD) in asymptomatic populations is unknown. Methods and results: From the prospective multicentre international CONFIRM long-term study, we evaluated asymptomatic subjects without known CAD who underwent both coronary artery calcium scoring (CACS) and CCTA (n = 1226). Coronary computed tomographic angiography findings included the severity of coronary artery stenosis, plaque composition, and coronary segment location. Using the C-statistic and likelihood ratio tests, we evaluated the incremental prognostic utility of CCTA findings over a base model that included a panel of traditional risk factors (RFs) as well as CACS to predict long-term all-cause mortality. During a mean follow-up of 5.9 ± 1.2 years, 78 deaths occurred. Compared with the traditional RF alone (C-statistic 0.64), CCTA findings including coronary stenosis severity, plaque composition, and coronary segment location demonstrated improved incremental prognostic utility beyond traditional RF alone (C-statistics range 0.71-0.73, all P < 0.05; incremental χ2 range 20.7-25.5, all P < 0.001). However, no added prognostic benefit was offered by CCTA findings when added to a base model containing both traditional RF and CACS (C-statistics P > 0.05, for all). Conclusions: Coronary computed tomographic angiography improved prognostication of 6-year all-cause mortality beyond a set of conventional RF alone, although, no further incremental value was offered by CCTA when CCTA findings were added to a model incorporating RF and CACS.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Tomografia Computadorizada por Raios X / Angiografia Coronária / Doenças Assintomáticas Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Tomografia Computadorizada por Raios X / Angiografia Coronária / Doenças Assintomáticas Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Heart J Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos