Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2820
Título: Long-Term Prognostic Impact of CT-Leaman Score in Patients with Non-Obstructive CAD: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) Study
Autor: Andreini, D
Pontone, G
Mushtaq, S
Gransar, H
Conte, E
Bartorelli, AL
Pepi, M
Opolski, M
Ó Hartaigh, B
Berman, D
Budoff, M
Achenbach, S
Al-Mallah, M
Cademartiri, Fi
Callister, T
Chang, HJ
Chinnaiyan, K
Chow, B
Cury, R
Delago, A
Hadamitzky, M
Hausleiter, J
Feuchtner, G
Kim, YJ
Kaufmann, PA
Leipsic, J
Lin, FY
Maffei, E
Raff, G
Shaw, LJ
Villines, TC
Dunning, A
Marques, H
Rubinshtein, R
Hindoyan, N
Gomez, M
Min, JK
Palavras-chave: Aged
Cause of Death
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Follow-Up Studies
Global Health
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Data: 15-Mar-2017
Editora: Elsevier
Citação: Int J Cardiol. 2017 Mar 15;231:18-25
Resumo: BACKGROUND: Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD). METHODS: From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (<50% stenosis). Segment-involvement score (SIS) and CT-LeSc were calculated. Outcomes were non-fatal myocardial infarction (MI) and the combined end-point of MI and all-cause mortality. RESULTS: Patient mean age was 56±12years. At follow-up (mean 59.8±13.9months), 183 events occurred (53 MI, 99 all-cause deaths and 31 late revascularizations). CT-LeSc was the only multivariate predictor of MI (HRs 2.84 and 2.98 in two models with Framingham and risk factors, respectively) and of MI plus all-cause mortality (HR 2.48 and 1.94 in two models with Framingham and risk factors, respectively). This was confirmed by a net reclassification analysis confirming that the CT-LeSc was able to correctly reclassify a significant proportion of patients (cNRI 0.28 and 0.23 for MI and MI plus all-cause mortality, respectively) vs. baseline model, whereas SIS did not. CONCLUSION: CT-LeSc is an independent predictor of major acute cardiac events, improving prognostic stratification of patients with non-obstructive CAD.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2820
DOI: 10.1016/j.ijcard.2016.12.137
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