Cited by 173Cardiac Imaging and DiagnosticsCoronary Interventions and DiagnosticsCoronary Artery Anomalies

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Meta-Analysis and Systematic Review of the Long-Term Predictive Value of Assessment of Coronary Atherosclerosis by Contrast-Enhanced Coronary Computed Tomography Angiography

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Bamberg, Fabian, Sommer, Wieland H., Hoffmann, Verena, Achenbach, Stephan, Nikolaou, Konstantin, Conen, David, Reiser, Maximilian F., Hoffmann, Udo, Becker, Christoph R.·2011·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2010.12.043

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Abstract

Objectives We conducted a systematic review and meta-analysis to determine the predictive value of findings of coronary computed tomography angiography for incident cardiovascular events. Background Initial studies indicate a prognostic value of the technique; however, the level of evidence as well as exact independent risk estimates remain unclear. Methods We searched PubMed, EMBASE, and the Cochrane Library through January 2010 for studies that followed up ≥ 100 subjects for ≥ 1 year and reported at ≥ 1 hazard ratio (HR) of interest. Risk estimates for the presence of significant coronary stenosis (primary endpoint; ≥ 50% diameter stenosis), left main coronary artery stenosis, each coronary stenosis, 3-vessel disease, any plaque, per coronary segment containing plaque, and noncalcified plaque were derived in random effect regression analysis, and causes of heterogeneity were determined in meta-regression analysis. Results We identified 11 eligible articles including 7,335 participants (age 59.1 ± 2.6 years, 62.8% male) with suspected coronary artery disease. The presence of ≥ 1 significant coronary stenosis (9 studies, 3,670 participants, and 252 outcome events [6.8%] with 62% revascularizations) was associated with an annualized event rate of 11.9% (6.4% in studies excluding revascularization). The corresponding HR was 10.74 (98% confidence interval [CI]: 6.37 to 18.11) and 6.15 (95% CI: 3.22 to 11.74) in studies excluding revascularization. Adjustment for coronary calcification did not attenuate the prognostic significance (p = 0.79). The estimated HRs for left main stenosis, presence of plaque, and each coronary segment containing plaque were 6.64 (95% CI: 2.6 to 17.3), 4.51 (95% CI: 2.2 to 9.3), and 1.23 (95% CI: 1.17 to 1.29), respectively. Conclusions Presence and extent of coronary artery disease on coronary computed tomography angiography are strong, independent predictors of cardiovascular events despite heterogeneity in endpoints, categorization of computed tomography findings, and study population.

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Authors: Bamberg, F., Sommer, W. H., Hoffmann, V., Achenbach, S., Nikolaou, K., Conen, D., Reiser, M. F., Hoffmann, U., & Becker, C. R.
Affiliations: Harvard University (US)
Ludwig-Maximilians-Universität München (DE)
Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
University Hospital of Basel (CH)
Corresponding author: Bamberg, Fabian
ORCID: Bamberg, Fabian
Hoffmann, Verena
Achenbach, Stephan
Nikolaou, Konstantin
Conen, David
Reiser, Maximilian F.
Hoffmann, Udo
Becker, Christoph R.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2011-06
Volume: 57
Issue: 24
Pages: 2426-2436
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2010.12.043
OpenAlex: W2086160762
Cited by: 173
References: 28
Citations by year: 2026: 5 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 8 · 2017: 16 · 2016: 14 · 2015: 19 · 2014: 23 · 2013: 23 · 2012: 23
FWCI: 3.94
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 776 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: Siemens
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Artery Anomalies
Keywords: coronary artery disease, coronary CT angiography, incident cardiovascular events, prognostic value, coronary artery stenosis, left main coronary artery stenosis, coronary plaque, non-calcified plaque, coronary artery calcification, revascularization, long-term follow-up, risk stratification, coronary heart disease risk prediction, coronary artery disease risk
MeSH terms: Aged, Contrast Media, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Radiographic Image Enhancement, Severity of Illness Index, Tomography, X-Ray Computed, Survival Rate, Coronary Angiography, Risk Assessment

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Meta-Analysis and Systematic Review of the Long-Term Predictive Value of Assessment of Coronary Atherosclerosis by Contrast-Enhanced Coronary Computed Tomography Angiography

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