Long-Term Prognostic Value of Coronary Computed Tomography Angiography in Asymptomatic Elderly Population Including Diabetic Patients

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 428-P
Author(s):  
SUN JOON MOON ◽  
DONG-HWA LEE ◽  
AE JUNG TOH ◽  
KYOUNG MIN KIM ◽  
SUNGHEE CHOI ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Prognostic Value ◽  
Elderly Population ◽  
Coronary Computed Tomography Angiography ◽  
Diabetic Patients ◽  
Coronary Computed Tomography

scholarly journals Prognostic value of coronary computed tomography angiography in diabetic patients without chest pain syndrome

2015 ◽  
Vol 23 (1) ◽  
pp. 24-36 ◽  
Author(s):  
Inge J. van den Hoogen ◽  
Michiel A. de Graaf ◽  
Cornelis J. Roos ◽  
Aukelien C. Leen ◽  
Aan V. Kharagjitsingh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Computed Tomography Angiography ◽  
Prognostic Value ◽  
Coronary Computed Tomography Angiography ◽  
Pain Syndrome ◽  
Diabetic Patients ◽  
Coronary Computed Tomography ◽  
Chest Pain Syndrome

scholarly journals Long-term prognostic value of coronary computed tomography angiography in chest pain patients

2018 ◽  
Vol 60 (1) ◽  
pp. 45-53
Author(s):  
Mårten Sandstedt ◽  
Jakob De Geer ◽  
Lilian Henriksson ◽  
Jan Engvall ◽  
Magnus Janzon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Arteries ◽  
Computed Tomography Angiography ◽  
Prognostic Value ◽  
Coronary Computed Tomography Angiography ◽  
Normal Coronary Arteries ◽  
Coronary Computed Tomography

Background Coronary computed tomography angiography (CCTA) is increasingly used to detect coronary artery disease (CAD), but long-term follow-up studies are still scarce. Purpose To evaluate the prognostic value of CCTA in patients with suspected CAD. Material and Methods A total of 1205 consecutive CCTA patients with chest pain were classified as normal coronary arteries, non-obstructive CAD, or obstructive CAD. The primary outcome was major adverse cardiac event (MACE), defined as a composite outcome including cardiac death, myocardial infarction, unstable angina pectoris, or late revascularization (after >90 days). Results Over 7.5 years follow-up (median = 3.1 years), Kaplan–Meier estimates demonstrated a MACE in 1.0%, 4.6%, and 20.7% in normal coronary arteries, non-obstructive CAD, and obstructive CAD, respectively. Log rank test for pairwise comparisons showed significant differences between non-obstructive CAD and normal coronary arteries ( P = 0.023) and between obstructive CAD and normal coronary arteries ( P < 0.001). In a multivariable analysis, adjusting for classical risk factors, non-obstructive CAD and obstructive CAD were independent predictors of MACE, with hazard ratios (HR) of 3.22 ( P = 0.041) and 25.18 ( P < 0.001), respectively. Conclusion Patients with normal coronary arteries have excellent long-term prognosis, but the risk for MACE increases with non-obstructive and obstructive CAD. Both non-obstructive and obstructive CAD are independently associated with future ischemic events.

scholarly journals Clinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry

2020 ◽  
Vol 21 (5) ◽  
pp. 479-488 ◽  
Author(s):  
Alexander R van Rosendael ◽  
A Maxim Bax ◽  
Jeff M Smit ◽  
Inge J van den Hoogen ◽  
Xiaoyue Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Prognostic Value ◽  
Coronary Computed Tomography Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Artery Disease

Abstract Aims In patients without obstructive coronary artery disease (CAD), we examined the prognostic value of risk factors and atherosclerotic extent. Methods and results Patients from the long-term CONFIRM registry without prior CAD and without obstructive (≥50%) stenosis were included. Within the groups of normal coronary computed tomography angiography (CCTA) (N = 1849) and non-obstructive CAD (N = 1698), the prognostic value of traditional clinical risk factors and atherosclerotic extent (segment involvement score, SIS) was assessed with Cox models. Major adverse cardiac events (MACE) were defined as all-cause mortality, non-fatal myocardial infarction, or late revascularization. In total, 3547 patients were included (age 57.9 ± 12.1 years, 57.8% male), experiencing 460 MACE during 5.4 years of follow-up. Age, body mass index, hypertension, and diabetes were the clinical variables associated with increased MACE risk, but the magnitude of risk was higher for CCTA defined atherosclerotic extent; adjusted hazard ratio (HR) for SIS &gt;5 was 3.4 (95% confidence interval [CI] 2.3–4.9) while HR for diabetes and hypertension were 1.7 (95% CI 1.3–2.2) and 1.4 (95% CI 1.1–1.7), respectively. Exclusion of revascularization as endpoint did not modify the results. In normal CCTA, presence of ≥1 traditional risk factors did not worsen prognosis (log-rank P = 0.248), while it did in non-obstructive CAD (log-rank P = 0.025). Adjusted for SIS, hypertension and diabetes predicted MACE risk in non-obstructive CAD, while diabetes did not increase risk in absence of CAD (P-interaction = 0.004). Conclusion Among patients without obstructive CAD, the extent of CAD provides more prognostic information for MACE than traditional cardiovascular risk factors. An interaction was observed between risk factors and CAD burden, suggesting synergistic effects of both.

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