Andreini, DPontone, GMushtaq, SGransar, HConte, EBartorelli, ALPepi, MOpolski, MÓ Hartaigh, BBerman, DBudoff, MAchenbach, SAl-Mallah, MCademartiri, FiCallister, TChang, HJChinnaiyan, KChow, BCury, RDelago, AHadamitzky, MHausleiter, JFeuchtner, GKim, YJKaufmann, PALeipsic, JLin, FYMaffei, ERaff, GShaw, LJVillines, TCDunning, AMarques, HRubinshtein, RHindoyan, NGomez, MMin, JK2017-12-112017-12-112017-03-15Int J Cardiol. 2017 Mar 15;231:18-25http://hdl.handle.net/10400.17/2820BACKGROUND: Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD). METHODS: From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (<50% stenosis). Segment-involvement score (SIS) and CT-LeSc were calculated. Outcomes were non-fatal myocardial infarction (MI) and the combined end-point of MI and all-cause mortality. RESULTS: Patient mean age was 56±12years. At follow-up (mean 59.8±13.9months), 183 events occurred (53 MI, 99 all-cause deaths and 31 late revascularizations). CT-LeSc was the only multivariate predictor of MI (HRs 2.84 and 2.98 in two models with Framingham and risk factors, respectively) and of MI plus all-cause mortality (HR 2.48 and 1.94 in two models with Framingham and risk factors, respectively). This was confirmed by a net reclassification analysis confirming that the CT-LeSc was able to correctly reclassify a significant proportion of patients (cNRI 0.28 and 0.23 for MI and MI plus all-cause mortality, respectively) vs. baseline model, whereas SIS did not. CONCLUSION: CT-LeSc is an independent predictor of major acute cardiac events, improving prognostic stratification of patients with non-obstructive CAD.engAgedCause of DeathComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseCoronary VesselsFemaleFollow-Up StudiesGlobal HealthHumansMalePredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsTime FactorsRegistriesHCC CIRjournal article10.1016/j.ijcard.2016.12.137