Prognostic Value of Coronary CT Angiography
Study Questions:

What is the prognostic value of coronary artery disease (CAD) identified on coronary computed tomography angiography (CCTA)?


This cohort study examined 16,949 patients from multiple centers with new-onset symptoms suggestive of CAD, and evaluated the relationship between CCTA findings and outcomes. Outcomes included late revascularization, myocardial infarction, and mortality.


Median age was 57 years, and 57% were women. CAD was absent, nonobstructive, and obstructive in 9,305, 4,900, and 2,744 subjects, respectively. Median follow-up was 3.6 years; late revascularization, myocardial infarction, and mortality were observed in 173, 105, and 261 individuals, respectively. The composite endpoint occurred in 1.5% of patients without CAD and 6.8% in those with obstructive CAD. Adjusted hazard ratios for events (using normal coronary arteries as a baseline) were 1.28 for nonobstructive CAD (95% confidence interval [CI], 1.01-1.63), 2.25 for obstructive CAD (95% CI, 1.73-2.92), and 4.41 (95% CI, 2.90-6.69) for three-vessel or left main obstructive CAD. By adding CAD identified by CCTA to a model using the Diamond-Forrester risk score and risk factors, the C-index for the model increased from 0.64 to 0.72 (p < 0.001).

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