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Long-term prognostic utility of computed tomography coronary angiography in older populations

Gnanenthiran, Sonali R ; Naoum, Christopher ; Leipsic, Jonathon A ; Achenbach, Stephan ; Al-Mallah, Mouaz H ; Andreini, Daniele ; Bax, Jeroen J ; Berman, Daniel S ; Budoff, Matthew J ; Cademartiri, Filippo ; Callister, Tracy Q ; Chang, Hyuk-Jae ; Chinnaiyan, Kavitha ; Chow, Benjamin J W ; Cury, Ricardo C ; DeLago, Augustin ; Feuchtner, Gudrun ; Hadamitzky, Martin ; Hausleiter, Joerg ; Kaufman, Philipp A ; Kim, Yong-Jin ; Maffei, Erica ; Marques, Hugo ; de Araújo Gonçalves, Pedro ; Pontone, Gianluca ; Raff, Gilbert L ; Rubinshtein, Ronen ; Shaw, Leslee J ; Villines, Todd C ; Gransar, Heidi ; Lu, Yao ; Jones, Erica C ; Peña, Jessica M ; Lin, Fay Y ; Kritharides, Leonard ; Min, James K

European heart journal cardiovascular imaging, 2019-11, Vol.20 (11), p.1279-1286 [Periódico revisado por pares]

England: Oxford University Press

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Título:
Long-term prognostic utility of computed tomography coronary angiography in older populations
Autor: Gnanenthiran, Sonali R ; Naoum, Christopher ; Leipsic, Jonathon A ; Achenbach, Stephan ; Al-Mallah, Mouaz H ; Andreini, Daniele ; Bax, Jeroen J ; Berman, Daniel S ; Budoff, Matthew J ; Cademartiri, Filippo ; Callister, Tracy Q ; Chang, Hyuk-Jae ; Chinnaiyan, Kavitha ; Chow, Benjamin J W ; Cury, Ricardo C ; DeLago, Augustin ; Feuchtner, Gudrun ; Hadamitzky, Martin ; Hausleiter, Joerg ; Kaufman, Philipp A ; Kim, Yong-Jin ; Maffei, Erica ; Marques, Hugo ; de Araújo Gonçalves, Pedro ; Pontone, Gianluca ; Raff, Gilbert L ; Rubinshtein, Ronen ; Shaw, Leslee J ; Villines, Todd C ; Gransar, Heidi ; Lu, Yao ; Jones, Erica C ; Peña, Jessica M ; Lin, Fay Y ; Kritharides, Leonard ; Min, James K
Assuntos: Age Factors ; Aged ; Aged, 80 and over ; Computed Tomography Angiography ; Coronary Angiography ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Registries
É parte de: European heart journal cardiovascular imaging, 2019-11, Vol.20 (11), p.1279-1286
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Abstract Aims The long-term prognostic value of coronary computed tomography angiography (CCTA)-identified coronary artery disease (CAD) has not been evaluated in elderly patients (≥70 years). We compared the ability of coronary CCTA to predict 5-year mortality in older vs. younger populations. Methods and results From the prospective CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry, we analysed CCTA results according to age <70 years (n = 7198) vs. ≥70 years (n = 1786). The severity of CAD was classified according to: (i) maximal stenosis degree per vessel: none, non-obstructive (1–49%), or obstructive (>50%); (ii) segment involvement score (SIS): number of segments with plaque. Cox-proportional hazard models assessed the relationship between CCTA findings and time to mortality. At a mean 5.6 ± 1.1 year follow-up, CCTA-identified CAD predicted increased mortality compared with patients with a normal CCTA in both <70 years [non-obstructive hazard ratio (HR) confidence interval (CI): 1.70 (1.19–2.41); one-vessel: 1.65 (1.03–2.67); two-vessel: 2.24 (1.21–4.15); three-vessel/left main: 4.12 (2.27–7.46), P < 0.001] and ≥70 years [non-obstructive: 1.84 (1.15–2.95); one-vessel: HR (CI): 2.28 (1.37–3.81); two-vessel: 2.36 (1.33–4.19); three-vessel/left main: 2.41 (1.33–4.36), P = 0.014]. Similarly, SIS was predictive of mortality in both <70 years [SIS 1–3: 1.57 (1.10–2.24); SIS ≥4: 2.42 (1.65–3.57), P < 0.001] and ≥70 years [SIS 1–3: 1.73 (1.07–2.79); SIS ≥4: 2.45 (1.52–3.93), P < 0.001]. CCTA findings similarly predicted long-term major adverse cardiovascular outcomes (MACE) (all-cause mortality, myocardial infarction, and late revascularization) in both groups compared with patients with no CAD. Conclusion The presence and extent of CAD is a meaningful stratifier of long-term mortality and MACE in patients aged <70 years and ≥70 years old. The presence of obstructive and non-obstructive disease and the burden of atherosclerosis determined by SIS remain important predictors of prognosis in older populations.
Editor: England: Oxford University Press
Idioma: Inglês

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Long-term prognostic utility of computed tomography coronary angiography in older populations

England: Oxford University Press

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