Usefulness of Cardiac Computed Tomography in Coronary Risk Prediction: A Five-Year Follow-Up of the SPICA Study (Secure Prevention with Imaging of the Coronary Arteries)

Journal of Clinical Medicine

Roberto Elosua¹  Jaume Marrugat¹  Anna Camps¹  Isaac Subirana¹  Irene R. Dégano¹  Rubén Leta Petracca²  Mireia Padilla²  David Viladés-Medel²  Martin Descalzo²  Francesc Carreras Costa²  Xavier Alomar Serrallach³  Xavier Mundet⁴ 

[1] CIBER de Enfermedades Cardio-Vasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;Cardiac Imaging Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona (UAB), 08193 Barcelona, Spain;Radiology Department, Clínica Creu Blanca, 08034 Barcelona, Spain;University Public Health Center El Carmel, Department of Medicine, Universitat Autonoma de Barcelona (UAB), 08193 Barcelona, Spain;

关键词: coronary artery disease risk;    cardiac computed tomography;    coronary artery calcium;    primary prevention;   

DOI  :  10.3390/jcm11030533

来源: DOAJ

【 摘 要 】

Accurate identification of individuals at high coronary risk would reduce acute coronary syndrome incidence and morbi-mortality. We analyzed the effect on coronary risk prediction of adding coronary artery calcification (CAC) and Segment Involvement Score (SIS) to cardiovascular risk factors. This was a prospective cohort study of asymptomatic patients recruited between 2013–2017. All participants underwent a coronary computed tomography angiography to determine CAC and SIS. The cohort was followed-up for a composite endpoint of myocardial infarction, coronary angiography and/or revascularization (median = five years). Discrimination and reclassification of the REGICOR function with CAC/SIS were examined with the Sommer’s D index and with the Net reclassification index (NRI). Nine of the 251 individuals included had an event. Of the included participants, 94 had a CAC = 0 and 85 a SIS = 0, none of them had an event. The addition of SIS or of SIS and CAC to the REGICOR risk function significantly increased the discrimination capacity from 0.74 to 0.89. Reclassification improved significantly when SIS or both scores were included. CAC and SIS were associated with five-year coronary event incidence, independently of cardiovascular risk factors. Discrimination and reclassification of the REGICOR risk function were significantly improved by both indexes, but SIS overrode the effect of CAC.

【 授权许可】

Unknown