Coronary CTA CONFIRM Study

  • Background

  • Aim

      • Examine mortality (or prognostic implications)

         in relation to coronary artery disease (CAD)

  • Method

    • Published in 2011
    • Multicenter CTA of the coronary arteries
    • consecutive cohort of 23,854
    • without known CAD
    • who presented with.
      • chest pain
        • atypical or
        • typical
    • Time to mortality was estimated using multivariable Cox proportional hazards models.
  • Result

    • Identified and classified CAD
      • none (0% stenosis),
      • mild (1% to 49% stenosis),
      • moderate (50% to 69% stenosis), or
      • severe (>70% stenosis).
    • 3  year survival without known CAD
    • Data from PROMISE Study
      PROMISE Study
      Survival related to number of vessels involved

      Survival Related to Number of Vessels Involved

    • Calcified and Non-Calcified Plaque
      Reconstruction of the coronary arteries shows predominantly non calcified plaque resulting in an elongated stenosis of the proximal LAD (maroon arrows) and short segment stenoses of the proximal RCA (red arrow) circumflex (blue arrow) and diagonal (white arrow) Scattered calcifications are lees prominent in the RCA and circumflex lesions
      Ashley Davidoff thecommonvein.net
      44047b
  • Conclusion

    • Among individuals without known CAD, nonobstructive and obstructive CAD by CCTA are associated with higher
      rates of mortality, with risk profiles differing for age and sex.
    • Importantly, absence of CAD is associated with a
      very favorable prognosis.
  • Relevance

    • When we identify CAD on any patient who is having a CT scan it is important to make note of
      • mild moderate or severe calcification
      • specify vessels
      • Patient with 3 vessel coronary calcification identified as an incidental finding
        Ashley Davidoff MD
        TheCommonVein.net
        Patient with 3 vessel coronary calcification identified as an incidental finding
        Ashley Davidoff MD
        TheCommonVein.net

         

 

  • Links and References

CONFIRM Min et al j.jacc.2011.02.074