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)
Por:
Vilades-Medel, D, Degano, IR, Subirana, I, Descalzo, M, Padilla, M, Mundet, X, Costa, FC, Serrallach, XA, Camps, A, Elosua, R, Marrugat, J, Petracca, RL
Publicada:
1 feb 2022
Resumen:
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.
Filiaciones:
Vilades-Medel, D:
Univ Autonoma Barcelona UAB, Cardiac Imaging Unit, Dept Cardiol, Hosp Santa Creu Sant Pau, Barcelona 08193, Spain
Degano, IR:
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Univ VicCentral Univ Catalonia UVic UCC, Fac Med, Vic 08500, Spain
Subirana, I:
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Descalzo, M:
Univ Autonoma Barcelona UAB, Cardiac Imaging Unit, Dept Cardiol, Hosp Santa Creu Sant Pau, Barcelona 08193, Spain
Padilla, M:
Univ Autonoma Barcelona UAB, Cardiac Imaging Unit, Dept Cardiol, Hosp Santa Creu Sant Pau, Barcelona 08193, Spain
Mundet, X:
Univ Autonoma Barcelona UAB, Univ Publ Hlth Ctr el Carmel, Dept Med, Barcelona 08193, Spain
IDIAP Jordi Gol, Barcelona Ciutat Res Support, RedIAPP, Barcelona 08007, Spain
Costa, FC:
Univ Autonoma Barcelona UAB, Cardiac Imaging Unit, Dept Cardiol, Hosp Santa Creu Sant Pau, Barcelona 08193, Spain
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Serrallach, XA:
Clin Creu Blanca, Radiol Dept, Barcelona 08034, Spain
Camps, A:
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Elosua, R:
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Univ VicCentral Univ Catalonia UVic UCC, Fac Med, Vic 08500, Spain
Marrugat, J:
CIBER Enfermedades Cardiovasc CIBERCV, Inst Salud Carlos 3, ISCIII, Madrid 28029, Spain
Hosp Mar Med Res Inst, REGICOR Study Grp, IMIM, Barcelona 08003, Spain
Petracca, RL:
Univ Autonoma Barcelona UAB, Cardiac Imaging Unit, Dept Cardiol, Hosp Santa Creu Sant Pau, Barcelona 08193, Spain
Green Published, gold
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