Work

Coronary computed tomographic angiography and atherosclerosis: prognostic validation of coronary scores in a Slovenian cohort

Year: 2026

Type: article

Abstract: BACKGROUND: Coronary computed tomographic angiography (CCTA) provides information on coronary atherosclerosis burden and extent. In the present analysis, we compared the prognostic impact of coronary scores (maximal coronary stenosis, segment involvement score [SIS] and segment stenosis scores [SSS], and the CCTA-modified Duke score). PATIENTS AND METHODS: We retrospectively reviewed CCTA images of patients with suspected coronary obstruction and excluded patients who underwent planned revascularization. Using Cox multivariate analysis, we estimated the hazard ratio (HR) with 95% confidence intervals (CI) for different coronary scores to predict death, myocardial infarction, and late unplanned revascularizations (as individual and composite endpoints). Model performance was evaluated using area under time-dependent receiver operating characteristic curves (AUC). RESULTS: We included 750 patients (median age 61 years, 54% women) with a median follow up 1,465 days. Unadjusted HR for major cardiovascular events ranged from 3.87 (95% CI 1.49-10.0, p = 0.005) for obstructive disease (> 50% stenosis in any vessel) to 1.17 (1.09-1.25, p < 0.001) for SIS (each additional segment involved). Predictions remained significant for all endpoints and after adjusting for coronary artery calcium score and risk factors. Area under curve (AUC) for coronary stenosis was 0.77 (95% CI 0.71-0.82), for SIS was 0.77 (95% CI 0.72-0.83), for SSS was 0.77 (95% CI 0.71-0.82), and for Duke score was 0.67 (95% CI 0.61-0.74). CONCLUSIONS: Our study has confirmed that coronary atherosclerosis burden and extent independently predict major cardiovascular events in patients who had undergone CCTA, but were not referred for invasive diagnostic procedures and revascularization.

Source: Radiology and Oncology

DOI: 10.2478/raon-2026-0004

Authors: Tadeja Poropat Flerin, Borut Jug, Daniel Kosuta

Institution: Ljubljana University Medical Centre

Language: English

Topic: Cardiac Imaging and Diagnostics

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $970