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

Lene H Nielsen; Hans Erik Bøtker; Henrik T Sørensen; Morten Schmidt; Lars Pedersen; Niels Peter Sand; Jesper Møller Jensen; Flemming H Steffensen; Hans Henrik Tilsted; Morten Bøttcher; Axel Diederichsen; Jess Lambrechtsen; Lone D Kristensen; Kristian A Øvrehus; Hans Mickley; Henrik Munkholm; Ole Gøtzsche; Majed Husain; Lars L Knudsen; Bjarne L Nørgaard

doi:10.1093/eurheartj/ehw548

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

Lene H Nielsen, Hans Erik Bøtker, Henrik T Sørensen, Morten Schmidt, Lars Pedersen, Niels Peter Sand, Jesper Møller Jensen, Flemming H Steffensen, Hans Henrik Tilsted, Morten Bøttcher, Axel Diederichsen, Jess Lambrechtsen, Lone D Kristensen, Kristian A Øvrehus, Hans Mickley, Henrik Munkholm, Ole Gøtzsche, Majed Husain, Lars L Knudsen, Bjarne L Nørgaard

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

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.

Original language	English
Journal	European Heart Journal
Volume	38
Issue	6
Pages (from-to)	413–421
Number of pages	9
ISSN	0195-668X
DOIs	https://doi.org/10.1093/eurheartj/ehw548
Publication status	Published - 2017

Keywords

Comorbidity
Coronary atherosclerosis
Coronary computed tomography angiography
Prognosis
Stable angina

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Nielsen, L. H., Bøtker, H. E., Sørensen, H. T., Schmidt, M., Pedersen, L., Sand, N. P., Jensen, J. M., Steffensen, F. H., Tilsted, H. H., Bøttcher, M., Diederichsen, A., Lambrechtsen, J., Kristensen, L. D., Øvrehus, K. A., Mickley, H., Munkholm, H., Gøtzsche, O., Husain, M., Knudsen, L. L., & Nørgaard, B. L. (2017). Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study. European Heart Journal, 38(6), 413–421. https://doi.org/10.1093/eurheartj/ehw548

@article{4367a92dce1d47bd9fe0ced9b5886df3,

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

abstract = "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.",

keywords = "Comorbidity, Coronary atherosclerosis, Coronary computed tomography angiography, Prognosis, Stable angina",

author = "Nielsen, {Lene H} and B{\o}tker, {Hans Erik} and S{\o}rensen, {Henrik T} and Morten Schmidt and Lars Pedersen and Sand, {Niels Peter} and Jensen, {Jesper M{\o}ller} and Steffensen, {Flemming H} and Tilsted, {Hans Henrik} and Morten B{\o}ttcher and Axel Diederichsen and Jess Lambrechtsen and Kristensen, {Lone D} and {\O}vrehus, {Kristian A} and Hans Mickley and Henrik Munkholm and Ole G{\o}tzsche and Majed Husain and Knudsen, {Lars L} and N{\o}rgaard, {Bjarne L}",

year = "2017",

doi = "10.1093/eurheartj/ehw548",

language = "English",

volume = "38",

pages = "413–421",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "6",

}

Nielsen, LH, Bøtker, HE , Sørensen, HT , Schmidt, M , Pedersen, L, Sand, NP, Jensen, JM, Steffensen, FH, Tilsted, HH, Bøttcher, M, Diederichsen, A, Lambrechtsen, J, Kristensen, LD, Øvrehus, KA, Mickley, H, Munkholm, H, Gøtzsche, O, Husain, M, Knudsen, LL & Nørgaard, BL 2017, 'Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study', European Heart Journal, vol. 38, no. 6, pp. 413–421. https://doi.org/10.1093/eurheartj/ehw548

Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study. / Nielsen, Lene H; Bøtker, Hans Erik ; Sørensen, Henrik T et al.
In: European Heart Journal, Vol. 38, No. 6, 2017, p. 413–421.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography

T2 - a Danish multicentre cohort study

AU - Nielsen, Lene H

AU - Bøtker, Hans Erik

AU - Sørensen, Henrik T

AU - Schmidt, Morten

AU - Pedersen, Lars

AU - Sand, Niels Peter

AU - Jensen, Jesper Møller

AU - Steffensen, Flemming H

AU - Tilsted, Hans Henrik

AU - Bøttcher, Morten

AU - Diederichsen, Axel

AU - Lambrechtsen, Jess

AU - Kristensen, Lone D

AU - Øvrehus, Kristian A

AU - Mickley, Hans

AU - Munkholm, Henrik

AU - Gøtzsche, Ole

AU - Husain, Majed

AU - Knudsen, Lars L

AU - Nørgaard, Bjarne L

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Comorbidity

KW - Coronary atherosclerosis

KW - Coronary computed tomography angiography

KW - Prognosis

KW - Stable angina

UR - http://www.scopus.com/inward/record.url?scp=85016229579&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehw548

DO - 10.1093/eurheartj/ehw548

M3 - Journal article

C2 - 27941018

SN - 0195-668X

VL - 38

SP - 413

EP - 421

JO - European Heart Journal

JF - European Heart Journal

IS - 6

ER -

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

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Keywords

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