Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study

Iksung Cho; Subhi J. Al’Aref; Adam Berger; Bríain ó Hartaigh; Heidi Gransar; Valentina Valenti; Fay Y. Lin; Stephan Achenbach; Daniel S. Berman; Matthew J. Budoff; Tracy Q. Callister; Mouaz H. Al‐Mallah; Filippo Cademartiri; Kavitha M. Chinnaiyan; Benjamin J.W. Chow; Augustin DeLago; Todd C. Villines; Martin Hadamitzky; Jöerg Hausleiter; Jonathon Leipsic; Leslee J. Shaw; Philipp A. Kaufmann; Gudrun Feuchtner; Yong‐Jin Kim; Erica Maffei; Gilbert Raff; Gianluca Pontone; Daniele Andreini; Hugo Marques; Ronen Rubinshtein; Hyuk‐Jae Chang; James K. Min

doi:10.1093/eurheartj/ehx774

Why the study?

Does coronary computed tomographic angiography improve prognostication of 6-year all-cause mortality in asymptomatic individuals compared to conventional risk factors and CACS?

Key Points

Determine the prognostic value of coronary computed tomographic angiography (CCTA) for predicting 6-year all-cause mortality in asymptomatic individuals relative to conventional risk factors and coronary artery calcium scoring.
Analyzed data from the prospective, multicenter, international CONFIRM study with a 6-year follow-up period in asymptomatic individuals.
Evaluated prognostic models for 6-year all-cause mortality incorporating conventional risk factors alone, risk factors plus coronary artery calcium score (CACS), and risk factors with CACS and CCTA findings.
Coronary computed tomographic angiography significantly improved prognostication of 6-year all-cause mortality compared to conventional risk factors alone.
CCTA findings provided no incremental prognostic value when added to a predictive model that already incorporated both conventional risk factors and coronary artery calcium scoring.

Structured PICO

Does coronary computed tomographic angiography improve prognostication of 6-year all-cause mortality in asymptomatic individuals compared to conventional risk factors and CACS?

P

Population

asymptomatic individuals

I

Intervention

Coronary computed tomographic angiography (CCTA)

C

Comparator

Conventional risk factors (RF) alone, and a model incorporating RF and coronary artery calcium score (CACS)

O

Outcome

6-year all-cause mortalityhard clinical

CCTA does not provide incremental prognostic value for 6-year all-cause mortality in asymptomatic individuals beyond conventional risk factors and coronary artery calcium scoring.

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Implication

Does not support adding CCTA to RF plus CACS for prognostication in asymptomatic adults; leaves open utility in selected subgroups.

Abstract

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.

Discussion

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Cite This Study

Cho et al. (2017) studied this question.

synapsesocial.com/papers/69eee00cb65c86b636037ebb https://doi.org/10.1093/eurheartj/ehx774

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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

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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