Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age
Heart and Vessels
© 2018 Springer Japan KK, part of Springer Nature 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.
Ayoub, Chadi; Kritharides, Leonard; Yam, Yeung; Chen, Li; Hossain, Alomgir; Achenbach, Stephan; Al-Mallah, Mouaz H.; Andreini, Daniele; Berman, Daniel S.; Budoff, Matthew J.; Cademartiri, Filippo; Callister, Tracy Q.; Chang, Hyuk Jae; Chinnaiyan, Kavitha; Cury, Ricardo C.; Delago, Augustin; Dunning, Allison; Feuchtner, Gudrun; Gomez, Millie; Gransar, Heidi; Hadamitzky, Martin; Hausleiter, Joerg; Hindoyan, Niree; Kaufmann, Philipp A.; Kim, Yong Jin; Leipsic, Jonathon; Maffei, Erica; Marques, Hugo; Pontone, Gianluca; Raff, Gilbert; Rubinshtein, Ronen; Shaw, Leslee J.; and Villines, Todd C., "Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age" (2018). Articles. 188.