Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study

Publikation: Forskning - peer reviewTidsskriftartikel

DOI

  • Lene H Nielsen
    Lene H NielsenDepartment of Cardiology, Lillebaelt Hospital-Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark lenehuche@gmail.com.
  • Hans Erik Bøtker
  • Henrik T Sørensen
    Henrik T Sørensen
  • Morten Schmidt
  • Lars Pedersen
    Lars Pedersen
  • Niels Peter Sand
    Niels Peter SandDepartment of Cardiology, Hospital of South West Jutland, Esbjerg, Denmark.
  • Jesper Møller Jensen
  • Flemming H Steffensen
    Flemming H SteffensenDepartment of Cardiology, Lillebaelt Hospital-Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark.
  • Hans Henrik Tilsted
    Hans Henrik TilstedDepartment of Cardiology, Aalborg University Hospital, Aalborg, Aalborg, Denmark.
  • Morten Bøttcher
  • Axel Diederichsen
    Axel DiederichsenDepartment of Cardiology, Odense University Hospital, Denmark.
  • Jess Lambrechtsen
    Jess LambrechtsenDepartment of Cardiology, Odense University Hospital, Svendborg, Denmark.
  • Lone D Kristensen
    Lone D KristensenDepartment of Cardiology, Diagnostic Centre, Regional Hospital Silkeborg, Silkeborg, Denmark.
  • Kristian A Øvrehus
    Kristian A Øvrehus
  • Hans Mickley
    Hans MickleyDepartment of Cardiology, Odense University Hospital, Denmark.
  • Henrik Munkholm
    Henrik MunkholmDepartment of Cardiology, Lillebaelt Hospital-Vejle, Kabbeltoft 25, DK-7100 Vejle, Denmark.
  • Ole Gøtzsche
  • Majed Husain
    Majed HusainDepartment of Cardiology, Hospital of South West Jutland, Esbjerg, Denmark.
  • Lars L Knudsen
    Lars L KnudsenDepartment of Cardiology, Regional Hospital West Jutland, Herning, Denmark.
  • Bjarne L Nørgaard
    Bjarne L Nørgaard

AIMS: To examine the 3.5 year prognosis of stable coronary artery disease (CAD) as assessed by coronary computed tomography angiography (CCTA) in real-world clinical practice, overall and within subgroups of patients according to age, sex, and comorbidity.

METHODS AND RESULTS: This cohort study included 16,949 patients (median age 57 years; 57% women) with new-onset symptoms suggestive of CAD, who underwent CCTA between January 2008 and December 2012. The endpoint was a composite of late coronary revascularization procedure >90 days after CCTA, myocardial infarction, and all-cause death. The Kaplan-Meier estimator was used to compute 91 day to 3.5 year risk according to the CAD severity. Comparisons between patients with and without CAD were based on Cox-regression adjusted for age, sex, comorbidity, cardiovascular risk factors, concomitant cardiac medications, and post-CCTA treatment within 90 days. The composite endpoint occurred in 486 patients. Risk of the composite endpoint was 1.5% for patients without CAD, 6.8% for obstructive CAD, and 15% for three-vessel/left main disease. Compared with patients without CAD, higher relative risk of the composite endpoint was observed for non-obstructive CAD [hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.01-1.63], obstructive one-vessel CAD (HR: 1.83; 95% CI: 1.37-2.44), two-vessel CAD (HR: 2.97; 95% CI: 2.09-4.22), and three-vessel/left main CAD (HR: 4.41; 95% CI :2.90-6.69). The results were consistent in strata of age, sex, and comorbidity.

CONCLUSION: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
ISSN0195-668X
DOI
StatusUdgivet - 9 dec. 2016

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