Long‐Term Prognostic Value of Coronary Computed Tomography Angiography in an Asymptomatic Elderly Population

Abstract

Background The prognostic value of coronary computed tomographic angiography (CCTA) for evaluating coronary artery disease in asymptomatic older adults is controversial. We investigated the prognostic value of CCTA in community‐dwelling elderly Koreans. Methods and Results Participants (n=470; mean age: 75.1±7.3 years) who underwent CCTA were enrolled from KLoSHA (Korean Longitudinal Study on Health and Aging), a community‐based prospective cohort. Using CCTA, coronary artery disease was classified as normal, nonobstructive, or obstructive according to the presence of 0%, P=0.027), whereas there were no significant differences in MACE between the normal and nonobstructive groups. The 8‐year event‐free survival rates were 98.1±1.1%, 94.9±1.6%, and 81.7±4.8% in the normal, nonobstructive, and obstructive groups, respectively. Compared with the Framingham risk score and coronary artery calcium score model, CCTA improved risk prediction by C‐index (from 0.698 to 0.749) and category‐free net reclassification index (0.478; P=0.022). Conclusions CCTA showed better long‐term prognostic value for MACE than coronary artery calcium score in this asymptomatic older population.