Five-Year Outcomes After Coronary Computed Tomography Angiography (From 110,599 Patients in a Danish Nationwide Register-Based Follow-Up Study)

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  • Kristian Kragholm, Aalborg University
  • ,
  • Jeppe Grøndahl Rasmussen, Aalborg University
  • ,
  • Marc Meller Søndergaard, Aalborg University
  • ,
  • Tomas Zaremba, Aalborg University
  • ,
  • Bhupendar Tayal, Aalborg University
  • ,
  • Filip Lyng Lindgren, Aalborg University
  • ,
  • Holger Marquard Sejersen, The North Denmark Region
  • ,
  • Martin Bødtker Mortensen
  • Bjarne Linde Nørgaard
  • Jesper Møller Jensen
  • Hans Erik Bøtker
  • Christina Byrne, University of Copenhagen
  • ,
  • Lars Køber, University of Copenhagen
  • ,
  • Christian Torp-Pedersen, University of Copenhagen
  • ,
  • Niels Holmark Andersen, Aalborg University
  • ,
  • Peter Søgaard, Aalborg University
  • ,
  • Mamas Mamas, Keele University
  • ,
  • Phillip Freeman, Aalborg University

The long-term cardiovascular risk for patients examined with coronary computed tomography angiography (CCTA) to rule out coronary heart disease compared with population controls remains unexplored. A nationwide register-based study including first-time CCTA-examined patients between 2007 and 2017 in Denmark alive 180 days post-CCTA was conducted. We evaluated 5-year outcomes of myocardial infarction (MI) or revascularization and all-cause mortality in 3 distinct CCTA-groups: (1) no post-CCTA preventive pharmacotherapy use (cholesterol-lowering drugs, antiplatelets, or anticoagulants); (2) post-CCTA preventive pharmacotherapy use; and (3) revascularization or MI within 180 days post-CCTA. For each patient group, population controls were matched on age, gender, and calendar year. Absolute risks standardized to the age, gender, selected co-morbidity, and anti-anginal pharmacotherapy distributions of the specific CCTA-examined patients and respective controls were obtained from multivariable Cox regression. Of 110,599 CCTA-examined patients, (1) 48,231 patients were not prescribed preventive pharmacotherapy 180 days post-CCTA; (2) 42,798 patients were prescribed preventive pharmacotherapy within 180 days post-CCTA; and (3) 19,570 patients were diagnosed with MI or revascularized within 180 days post-CCTA. For patient groups 1 to 3 versus respective controls, 5-year MI or revascularization risks were <0.1% versus 2.0%, <0.1% versus 3.8%, and 19.0% versus 2.5%, all p<0.001. Five-year all-cause mortality were 2.8% versus 4.2%, 5.5% versus 8.8%, and 6.7% versus 8.5%, all p <0.001. In conclusion, the 5-year MI or revascularization risk can be considered very low for CCTA-examined patients without ischemic events within 180 days post-CCTA. Conversely, CCTA-examined patients with MI or revascularization events within 180 days post-CCTA have significantly elevated 5-year MI or revascularization risk.

Original languageEnglish
JournalThe American Journal of Cardiology
Pages (from-to)1-7
Publication statusPublished - Aug 2022

Bibliographical note

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

    Research areas

  • Computed Tomography Angiography, Coronary Angiography/methods, Coronary Artery Disease/diagnostic imaging, Denmark/epidemiology, Follow-Up Studies, Humans, Myocardial Infarction/epidemiology, Myocardial Revascularization

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