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Browsing by Author "Yam, Y"

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  • Prognostic Value of Age Adjusted Segment Involvement Score As Measured by Coronary Computed Tomography: a Potential Marker of Vascular Age
    Publication . Ayoub, C; Kritharides, L; Yam, Y; Chen, L; Hossain, A; Achenbach, S; Al-Mallah, M; Andreini, D; Berman, D; Budoff, M; Cademartiri, F; Callister, T; Chang, HJ; Chinnaiyan, K; Cury, R; Delago, A; Dunning, A; Feuchtner, G; Gomez, M; Gransar, H; Hadamitzky, M; Hausleiter, J; Hindoyan, N; Kaufmann, P; Kim, YJ; Leipsic, J; Maffei, E; Marques, H; Pontone, G; Raff, G; Rubinshtein, R; Shaw, L; Villines, T; Min, J; Chow, B
    Extent of coronary atherosclerotic disease (CAD) burden on coronary computed tomography angiography (CCTA) as measured by segment involvement score (SIS) has a prognostic value. We sought to investigate the incremental prognostic value of 'age adjusted SIS' (aSIS), which may be a marker of premature atherosclerosis and vascular age. Consecutive patients were prospectively enrolled into the CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicentre) multinational observational study. Patients were followed for the outcome of all-cause death. aSIS was calculated on CCTA for each patient, and its incremental prognostic value was evaluated. A total of 22,211 patients [mean age 58.5 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (IQR 17.8, 35.4)] were identified. After adjustment for clinical factors and presence of obstructive CAD, higher aSIS was associated with increased death on multivariable analysis, with hazard ratio (HR) 2.40 (1.83-3.16, p < 0.001), C-statistic 0.723 (0.700-0.756), net reclassification improvement (NRI) 0.36 (0.26-0.47, p < 0.001), and relative integrated discrimination improvement (IDI) 0.33 (p = 0.009). aSIS had HR 3.48 (2.33-5.18, p < 0.001) for mortality in those without obstructive CAD, compared to HR 1.79 (1.25-2.58, p = 0.02) in those with obstructive CAD. In conclusion, aSIS has an incremental prognostic value to traditional risk factors and obstructive CAD, and may enhance CCTA risk stratification.
    2018-11Journal article Open access Show more