What question did this study set out to answer?

To determine the relationship between all-cause mortality and the extent and severity of coronary artery disease identified by coronary computed tomographic angiography (CCTA).

May 3, 2026Journal of the American College of Cardiology

Prognostic Value of Multidetector Coronary Computed Tomographic Angiography for Prediction of All-Cause Mortality

Q: What are the key findings of this study?

CCTA-defined CAD severity predicted all-cause mortality, with survival ranging from 99.7% for <50% stenosis to 85% for ≥50% left main artery stenosis (P<0.0001).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chest symptoms (n=1127). Intervention: CCTA-defined extent and severity of coronary artery disease vs. Minimal or no CAD (<50% stenosis). Primary outcome: All-cause death (p=<0.0001).

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Key result

Severe CAD on CCTA is linked to lower survival, dropping to ~85% with left main disease.

P<0.0001
n=1,127

Why the study?

The prognostic value of identifying coronary artery disease by coronary computed tomographic angiography remains undefined.

Does CCTA-defined extent and severity of coronary artery disease predict all-cause mortality in patients ≥45 years old with chest symptoms?

Key Points

To determine the relationship between all-cause mortality and the extent and severity of coronary artery disease identified by coronary computed tomographic angiography (CCTA).
Evaluated a single-center consecutive cohort of 1,127 patients aged ≥45 years presenting with chest symptoms.
Scored stenosis per coronary artery from minimal (<30%) to severe (≥70%) and evaluated plaque using obstructive criteria, a modified Duke score, and clinical distribution scores.
Assessed all-cause mortality over a 15.3 ± 3.9-month follow-up using multivariable Cox proportional hazards models adjusted for pretest risk factors.
Proximal left anterior descending artery stenosis and the number of vessels with ≥50% and ≥70% stenosis significantly predicted death (all p < 0.0001).
Survival was 99.7% in patients with <50% stenosis, but dropped to 96% for 1 vessel ≥70% or 2 vessels ≥50% (p = 0.013) and to 85% for ≥50% left main artery stenosis (p < 0.0001).
Clinical scores reflecting plaque burden and distribution predicted a 5% to 6% higher absolute death rate (6.6% vs. 1.6% and 8.4% vs. 2.5%; both p = 0.05).

Study Design

Type

Cohort (n=1,127)

Multicenter

Structured PICO

Does CCTA-defined extent and severity of coronary artery disease predict all-cause mortality in patients ≥45 years old with chest symptoms?

Population

1,127 patients ≥45 years old with chest symptoms evaluated by CCTA and followed for a mean of 15.3 months.

Exposure

Coronary computed tomographic angiography (CCTA) to assess coronary artery disease extent, severity, and plaque burden

Outcome

All-cause death verified by the Social Security Death Index at 15.3 ± 3.9 months follow-uphard clinical

Main Result

p-value: p=<0.0001

Discussion

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Implication

CCTA-defined CAD severity and plaque burden strongly predict all-cause mortality in symptomatic patients, with a negative scan indicating an extremely low risk of death.

Cite This Study

Min et al. (2007) conducted a cohort in Chest symptoms (n=1,127). CCTA-defined extent and severity of coronary artery disease vs. Minimal or no CAD (<50% stenosis) was evaluated on All-cause death (p=<0.0001). CCTA-defined CAD severity predicted all-cause mortality, with survival ranging from 99.7% for <50% stenosis to 85% for ≥50% left main artery stenosis (P<0.0001).

synapsesocial.com/papers/69f6bea6948acd347ea349a8 https://doi.org/10.1016/j.jacc.2007.03.067

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Implication

CCTA-defined CAD severity and plaque burden strongly predict all-cause mortality in symptomatic patients, with a negative scan indicating an extremely low risk of death.

Prognostic Value of Multidetector Coronary Computed Tomographic Angiography for Prediction of All-Cause Mortality

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Prognostic Value of Multidetector Coronary Computed Tomographic Angiography for Prediction of All-Cause Mortality

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider