Abstract 13147: The Prognostic Value of Coronary CTA in Young versus Older Patients Depends on the Outcome
Introduction: Considerable debate exists on the optimal outcome in cardiovascular (CV) prognostic studies, particularly across different age groups.
Objective: We sought to compare the use of all-cause death and CV events (CV death or MI) among patients undergoing coronary computed tomography angiography (CCTA) across different age groups.
Methods: We included all consecutive patients with no known coronary artery disease (CAD) referred for CCTA. Severity of CAD was categorized as non-obstructive (normal or <50% stenosis) in 1525 (77%) patients or obstructive (≥50% stenosis) in 717 (23% ) of the patients. Age was categorized as young (< 60 years-old) in 2008 (62%) patients or old (≥60 years old) in 1234 (38%). Blinded event adjudication was performed for all-cause death, CV death or myocardial infarction (MI).
Results: Among 3242 patients (58% males, 56±13 years), 92 (2.8%) CV events and 144 (4.4%) all-cause deaths occurred over a median follow up of 3.6 years (IQ: 2.1 - 5.0). While the presence of obstructive CAD was equally associated with CV death or MI in younger and older individuals, the association between obstructive CAD and all-cause death was only significant for younger individuals both in the crude analysis and after adjustment for the pretest probability of disease (figure).
Conclusions: While the association of CAD with CV events is equal for younger and older individuals, the association of CAD with all-cause death was attenuated by age in our study.These suggests that the use of all-cause death among older patients referred for coronary CTA may be less representative of cardiovascular events and it may attenuate potentially significant differences in patient outcomes.
Author Disclosures: M. Bittencourt: None. E. Hulten: None. B. Gohshhajra: None. M. Cheezum: None. U. Hoffmann: None. S. Abbara: None. M. Di Carli: None. P.A. Lotufo: None. R. Blankstein: None.
- © 2015 by American Heart Association, Inc.