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Long-Term Prognostic Value of Coronary Computed Tomography Angiography in an Asymptomatic Elderly Population

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Issue Date
2019-12
Publisher
Wiley-Blackwell
Citation
Journal of the American Heart Association, Vol.8 No.23
Abstract
Background The prognostic value of coronary computed tomographic angiography (CCTA) for evaluating coronary artery disease in asymptomatic older adults is controversial. We investigated the prognostic value of CCTA in community-dwelling elderly Koreans. Methods and Results Participants (n=470; mean age: 75.1 +/- 7.3 years) who underwent CCTA were enrolled from KLoSHA (Korean Longitudinal Study on Health and Aging), a community-based prospective cohort. Using CCTA, coronary artery disease was classified as normal, nonobstructive, or obstructive according to the presence of 0%, <50%, or >= 50% stenosis, respectively. Coronary artery calcium scores were investigated together with Framingham risk score, atherosclerotic cardiovascular disease score, and individual risk factors. Major adverse cardiac events (MACE) were defined as a composite of cardiac event-related death or nonfatal myocardial infarction. During a median follow-up of 8.2 years (interquartile range: 7.7-10.1 years), MACE occurred in 24 participants (5.1%). Compared with the normal group, participants in the obstructive group showed higher incidence of MACE (hazard ratio: 5.65; 95% CI, 1.22-26.16; P=0.027), whereas there were no significant differences in MACE between the normal and nonobstructive groups. The 8-year event-free survival rates were 98.1 +/- 1.1%, 94.9 +/- 1.6%, and 81.7 +/- 4.8% in the normal, nonobstructive, and obstructive groups, respectively. Compared with the Framingham risk score and coronary artery calcium score model, CCTA improved risk prediction by C-index (from 0.698 to 0.749) and category-free net reclassification index (0.478; P=0.022). Conclusions CCTA showed better long-term prognostic value for MACE than coronary artery calcium score in this asymptomatic older population.
ISSN
2047-9980
URI
https://hdl.handle.net/10371/179567
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Graduate School of Convergence Science and Technology (융합과학기술대학원)Dept. of Molecular and Biopharmaceutical Sciences (분자의학 및 바이오제약학과)Journal Papers (저널논문_분자의학 및 바이오제약학과)
Graduate School of Convergence Science and Technology (융합과학기술대학원)Dept. of Molecular and Biopharmaceutical Sciences (분자의학 및 바이오제약학과)Journal Papers (저널논문_분자의학 및 바이오제약학과)
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