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Added value of cardiovascular calcifications for prediction of recurrent cardiovascular events and cardiovascular interventions in patients with established cardiovascular disease.
van 't Klooster, Cilie C; van der Graaf, Yolanda; Nathoe, Hendrik M; Bots, Michiel L; de Borst, Gert J; Visseren, Frank L J; Leiner, Tim.
Afiliación
  • van 't Klooster CC; Department of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
  • van der Graaf Y; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.
  • Nathoe HM; Department of Cardiology, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.
  • Bots ML; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.
  • de Borst GJ; Department of Vascular Surgery, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.
  • Visseren FLJ; Department of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands. f.l.j.visseren@umcutrecht.nl.
  • Leiner T; Department of Radiology, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, The Netherlands.
Int J Cardiovasc Imaging ; 37(6): 2051-2061, 2021 Jun.
Article en En | MEDLINE | ID: mdl-33580447
The purpose is to investigate the added prognostic value of coronary artery calcium (CAC), thoracic aortic calcium (TAC), and heart valve calcium scores for prediction of a combined endpoint of recurrent major cardiovascular events and cardiovascular interventions (MACE +) in patients with established cardiovascular disease (CVD). In total, 567 patients with established CVD enrolled in a substudy of the UCC-SMART cohort, entailing cardiovascular CT imaging and calcium scoring, were studied. Five Cox proportional hazards models for prediction of 4-year risk of MACE + were developed; traditional CVD risk predictors only (model I), with addition of CAC (model II), TAC (model III), heart valve calcium (model IV), and all calcium scores (model V). Bootstrapping was performed to account for optimism. During a median follow-up of 3.43 years (IQR 2.28-4.74) 77 events occurred (MACE+). Calibration of predicted versus observed 4-year risk for model I without calcium scores was good, and the c-statistic was 0.65 (95%CI 0.59-0.72). Calibration for models II-V was similar to model I, and c-statistics were 0.67, 0.65, 0.65, and 0.68 for model II, III, IV, and V, respectively. NRIs showed improvement in risk classification by model II (NRI 15.24% (95%CI 0.59-29.39)) and model V (NRI 20.00% (95%CI 5.59-34.92)), but no improvement for models III and IV. In patients with established CVD, addition of the CAC score improved performance of a risk prediction model with classical risk factors for the prediction of the combined endpoint MACE+ . Addition of the TAC or heart valve score did not improve risk predictions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Enfermedades Cardiovasculares / Calcificación Vascular Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Enfermedades Cardiovasculares / Calcificación Vascular Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2021 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos