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Published on: August 28, 2018
Coronary Artery Computed Tomography Angiography for Preventing Cardio-Cerebrovascular Disease: Observational Cohort
Woo Kyung Bae1, Jihoon Cho2, Seok Kim2
1Department of Family Medicine, Health Promotion Center, Seoul National University Bundang Hospital, Republic of Korea, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Insights
Coronary artery computed tomography angiography (CCTA) screening shows no significant 5-year benefit for cardiovascular disease (CVD) outcomes. However, CCTA may improve risk score management within 2 years.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Imaging
Background:
- Cardio-cerebrovascular diseases (CVDs) are a leading cause of global mortality.
- Coronary artery computed tomography angiography (CCTA) detects coronary calcification for early vascular disease identification.
- CCTA offers noninvasive testing but involves radiation exposure.
Purpose of the Study:
- To evaluate the effectiveness of CCTA screening on CVD outcomes.
- Utilized Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) data for population-level estimation.
- Investigated CCTA's impact on cardiovascular disease risk.
Main Methods:
- Compared 5-year CVD outcomes between CCTA screening and a control group using propensity score matching.
- Included adults aged 30-74 without prior CVD history.
- Stratified participants by ASCVD and Framingham risk scores for subgroup analysis.
Main Results:
- No significant difference in 5-year CVD hazard ratios between CCTA and control groups.
- Subgroup analyses showed no significant 5-year differences in ASCVD or Framingham risk scores.
- The CCTA group demonstrated a significantly lower increase in risk scores at 2 years.
Conclusions:
- CCTA screening did not demonstrate a significant preventive effect on CVDs over 5 years.
- CCTA may offer benefits in managing cardiovascular risk scores within a 2-year timeframe.
- Further research may clarify long-term benefits of CCTA screening.
Background:
Cardio-cerebrovascular diseases (CVDs) result in 17.5 million deaths annually worldwide, accounting for 46.2% of noncommunicable causes of death, and are the leading cause of death, followed by cancer, respiratory disease, and diabetes mellitus. Coronary artery computed tomography angiography (CCTA), which detects calcification in the coronary arteries, can be used to detect asymptomatic but serious vascular disease. It allows for noninvasive and quick testing despite involving radiation exposure.
Objective:
The objective of our study was to investigate the effectiveness of CCTA screening on CVD outcomes by using the Observational Health Data Sciences and Informatics' Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) data and the population-level estimation method.
Methods:
Using electronic health record-based OMOP-CDM data, including health questionnaire responses, adults (aged 30-74 years) without a history of CVD were selected, and 5-year CVD outcomes were compared between patients undergoing CCTA (target group) and a comparison group via 1:1 propensity score matching. Participants were stratified into low-risk and high-risk groups based on the American College of Cardiology/American Heart Association atherosclerotic cardiovascular disease (ASCVD) risk score and Framingham risk score (FRS) for subgroup analyses.
Results:
The 2-year and 5-year risk scores were compared as secondary outcomes between the two groups. In total, 8787 participants were included in both the target group and comparison group. No significant differences (calibration P=.37) were found between the hazard ratios of the groups at 5 years. The subgroup analysis also revealed no significant differences between the ASCVD risk scores and FRSs of the groups at 5 years (ASCVD risk score: P=.97; FRS: P=.85). However, the CCTA group showed a significantly lower increase in risk scores at 2 years (ASCVD risk score: P=.03; FRS: P=.02).
Conclusions:
Although we could not confirm a significant difference in the preventive effects of CCTA screening for CVDs over a long period of 5 years, it may have a beneficial effect on risk score management over 2 years.
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