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.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Andreini Daniele, Pontone Gianluca, Mushtaq Saima, Gransar Heidi, Conte Edoardo, Bartorelli Antonio L, Pepi Mauro, Opolski Maksymilian P, Ó Hartaigh Bríain, Berman Daniel S, Budoff Matthew J, Achenbach Stephan, Al-Mallah Mouaz, Cademartiri Filippo, Callister Tracy Q, Chang Hyuk-Jae, Chinnaiyan Kavitha, Chow Benjamin J W, Cury Ricardo, Delago Augustin, Hadamitzky Martin, Hausleiter Joerg, Feuchtner Gudrun, Kim Yong-Jin, Kaufmann Philipp A, Leipsic Jonathon, Lin Fay Y, Maffei Erica, Raff Gilbert, Shaw Leslee J, Villines Todd C, Dunning Allison, Marques Hugo, Rubinshtein Ronen, Hindoyan Niree, Gomez Millie, Min James K
Аннотация
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.