Abstract 14571: Prognostic Value of 64-Detector Row Coronary CT Angiography for the Prediction of All-Cause Mortality: Results from 21,062 Patients in the Prospective Multinational CONFIRM Registry (Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter Registry)
Background: Prior studies examining coronary computed tomographic angiography (CCTA) have demonstrated increased mortality risk for individuals with obstructive coronary artery disease (CAD), but have been limited by evaluation in single centers, smaller populations, and using older-generation CCTA scanners.
Methods: We evaluated 21,062 consecutive patients (59±13 years; 57% male) without known CAD at 9 centers who underwent clinically-indicated 64-detector row CCTA. All-cause mortality (n=703; 3.4%) was studied during a 2.6±1.7 year follow-up in relation to the extent and severity of CAD by CCTA, considering the presence of any CAD as well as the presence of obstructive CAD in increasing numbers of major epicardial vessels.
Results: The mortality risk of normal coronary arteries was very low [1%, (75/7826)]. In univariate Cox regression analysis, as compared to patients with no CAD, mortality increased for non-obstructive CAD [Hazard Ratio (HR) 3.31, (95% Confidence Interval (CI) 2.56–4.27), p<0.0001] and obstructive 1-vessel [HR=5.05 (3.83, 6.67), p<0.0001], 2-vessel [HR=7.50 (95% CI 5.61, 10.04), p<0.0001], 3 vessel or Left Main [HR=11.0 (95% CI 8.09, 14.96), p<0.0001] CAD. In multivariate Cox regression presence of non-obstructive CAD [HR=2.50, (95% CI 1.91, 3.26), p<0.0001] and obstructive 1-vessel [HR=2.99 (2.24, 4.01), p<0.0001], 2-vessel [HR = 4.16 (3.07, 5.63), p<0.0001], and 3 vessel or Left Main CAD [HR = 5.59 (4.04, 7.72), p<0.0001] resulted in graded risk of mortality when compared to those with no CAD independent of cardiac risk factors.
Conclusions: During a 2.6 year follow-up of patients undergoing CCTA, measures of both non-obstructive and obstructive CAD stratify individuals at increased risk of death.
- © 2010 by American Heart Association, Inc.