Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality
Open accessAbstract
Objectives The purpose of this study was to examine the association of all-cause death with the coronary computed tomographic angiography (CCTA)-defined extent and severity of coronary artery disease (CAD). Background The prognostic value of identifying CAD by CCTA remains undefined. Methods We examined a single-center consecutive cohort of 1,127 patients > or =45 years old with chest symptoms. Stenosis by CCTA was scored as minimal ( or =70%) for each coronary artery. Plaque was assessed in 3 ways: 1) moderate or obstructive plaque; 2) CCTA score modified from Duke coronary artery score; and 3) simple clinical scores grading plaque extent and distribution. A 15.3 +/- 3.9-month follow-up of all-cause death was assessed using Cox proportional hazards models adjusted for pretest CAD likelihood and risk factors. Deaths were verified by the Social Security Death Index. Results The CCTA predictors of death included proximal left anterior descending artery stenosis and number of vessels with > or =50% and > or =70% stenosis (all p or =70% or 2 stenoses > or =50% (p = 0.013) to 85% survival for > or =50% LM artery stenosis (p Conclusions In patients with chest pain, CCTA identifies increased risk for all-cause death. Importantly, a negative CCTA portends an extremely low risk for death.
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Non-calcified/mixed characteristics, a stenosis grade of ≥50%, and the proximal location of coronary plaques are established risk factors for ischaemic heart disease.
“The non-calcified/mixed characteristics, a stenosis grade of ≥50%, and the proximal location of coronary plaques are all established risk factors for ischaemic heart disease.14,21”
From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [14]
Overall coronary plaque burden is associated with higher mortality risk.
“the overall coronary plaque burden, which is associated with higher mortality risk”
From Lifelong endurance exercise and its relation with coronary atherosclerosis (2023) · cites this paper as [14]
Calcified plaques are considered more stable and less prone to rupture compared with mixed or non-calcified plaques, which are associated with a higher risk of adverse cardiovascular events.
“as calcified plaques are considered more stable and less prone to rupture compared with mixed or non-calcified plaques, which are associated with a higher risk of adverse cardiovascular events.21 22”
From Resting and exercise-induced occult hypertension and coronary atherosclerosis in male masters endurance athletes (2026) · cites this paper as [21]
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Lifelong endurance exercise and its relation with coronary atherosclerosis
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“The SIS was calculated as the sum of coronary segments with plaques irrespective of the degree of luminal stenosis (minimum = 0; maximum = 15).(14) The SSS and SIS have demonstrated clinical validity in detecting major adverse cardiac events in multiple populations.”
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“21 22 However, recent findings report that lifelong endurance athletes had more coronary plaques, including more non-calcified plaques, compared with fit and healthy individuals with a similarly low cardiovascular risk profile.”
- Authors
- Min, J. K., Shaw, L. J., Devereux, R. B., Okin, P. M., Weinsaft, J. W., Russo, D. J., Lippolis, N. J., Berman, D. S., & Callister, T. Q.
- Affiliations
- NewYork–Presbyterian Hospital (US)
- Cedars-Sinai Medical Center (US)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-09
- Volume
- 50
- Issue
- 12
- Pages
- 1161-1170
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2090087329
- Cited by
- 1,055
- References
- 1
- Citations by year
- 2026: 34 · 2025: 35 · 2024: 46 · 2023: 55 · 2022: 54 · 2021: 51 · 2020: 52 · 2019: 41 · 2018: 48 · 2017: 45 · 2016: 55 · 2015: 58 · 2014: 62 · 2013: 54 · 2012: 61
- FWCI
- 55.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Coronary Artery Anomalies
- Keywords
- coronary artery disease, all-cause mortality, coronary artery stenosis, plaque burden, left main coronary artery stenosis, risk stratification, chest pain, prognosis
- MeSH terms
- Aged, Cause of Death, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Probability, Prognosis, Sensitivity and Specificity, Severity of Illness Index, Tomography, X-Ray Computed, Cohort Studies, Survival Analysis, Coronary Angiography
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