<P><B>Abstract</B></P><P><B>Aims</B></P><P>Coronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events be...
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https://www.riss.kr/link?id=A107464088
Han, Donghee ; Hartaigh, Brí ; ain Ó ; Gransar, Heidi ; Lee, Ji Hyun ; Rizvi, Asim ; Baskaran, Lohendran ; Schulman-Marcus, Joshua ; Dunning, Allison ; Achenbach, Stephan ; Al-Mallah, Mouaz H ; Berman, Daniel S ; Budoff, Matthew J ; Cademartiri, Filippo ; Maffei, Erica ; Callister, Tracy Q ; Chinnaiyan, Kavitha ; Chow, Benjamin J W ; DeLago, Augustin ; Hadamitzky, Martin ; Hausleiter, Joerg ; Kaufmann, Philipp A ; Raff, Gilbert ; Shaw, Leslee J ; Villines, Todd C ; Kim, Yong-Jin ; Leipsic, Jonathon ; Feuchtner, Gudrun ; Cury, Ricardo C ; Pontone, Gianluca ; Andreini, Daniele ; Marques, Hugo ; Rubinshtein, Ronen ; Hindoyan, Niree ; Jones, Erica C ; Gomez, Millie ; Lin, Fay Y ; Chang, Hyuk-Jae ; Min, James K
2018
-
SCOPUS,SCIE
학술저널
675-683(9쪽)
0
상세조회0
다운로드다국어 초록 (Multilingual Abstract)
<P><B>Abstract</B></P><P><B>Aims</B></P><P>Coronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events be...
<P><B>Abstract</B></P><P><B>Aims</B></P><P>Coronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events beyond traditional risk assessment. Age is a risk factor with very high weight and little is known regarding the incremental value of CCTA over CAC for predicting cardiac events in older adults.</P><P><B>Methods and results</B></P><P>Of 27 125 individuals undergoing CCTA, a total of 3145 asymptomatic adults were identified. This study sample was categorized according to tertiles of age (cut-off points: 52 and 62 years). CAD severity was classified as 0, 1–49, and ≥50% maximal stenosis in CCTA, and further categorized according to number of vessels ≥50% stenosis. The Framingham 10-year risk score (FRS) and CACS were employed as major covariates. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death or non-fatal MI. During a median follow-up of 26 months (interquartile range: 18–41 months), 59 (1.9%) MACE occurred. For patients in the top age tertile, CCTA improved discrimination beyond a model included FRS and CACS (C-statistic: 0.75 vs. 0.70, <I>P</I>-value = 0.015). Likewise, the addition of CCTA improved category-free net reclassification (cNRI) of MACE in patients within the highest age tertile (e.g. cNRI = 0.75; proportion of events/non-events reclassified were 50 and 25%, respectively; <I>P</I>-value <0.05, all). CCTA displayed no incremental benefit beyond FRS and CACS for prediction of MACE in the lower age tertiles.</P><P><B>Conclusion</B></P><P>CCTA provides added prognostic value beyond cardiac risk factors and CACS for the prediction of MACE in asymptomatic older adults.</P>