Coronary Computed Tomography Angiography in Prediction of First Coronary Events
Main finding · Risk prediction of first coronary eventsResult — go to the resultNet reclassification improvement 0.133 95% CI 0.031–0.165Authors' conclusion
Information on coronary atherosclerosis from CCTA modestly improved risk prediction beyond traditional risk factors and CACS in identifying individuals at risk of coronary events
Study context
- Population
- Individuals aged 50–64 years from the general population without previous CVD, with high-quality coronary computed tomography angiography (CCTA), Sweden 2013–2018304 coronary events
- Participants
- 24,791 individuals
- Exposure
- Pooled cohort equation (PCE) + coronary artery calcification score (CACS) + CCTA-derived atherosclerosis data vs PCE + CACS
- Outcome
- First nonfatal MI or death from CHD
- Follow-up
- Median 7.8 years
Methodological detailsobservational, 6 university hospitals in Sweden, population-based random recruitment
- Observational
- 6 university hospitals in Sweden
- Population-based random recruitment
Main finding
Risk prediction of first coronary events
Net reclassification improvement
0.133
95% CI 0.031–0.165
By group
PCE + CACS + CCTA
0.779
C statistic
PCE + CACS
0.764
C statistic
As reported in the abstract
Observational data: associations, not effects.
Further findings
First coronary event by CCTA findings
| Hazard ratio (95% CI) | ||
|---|---|---|
| Segment involvement scores of 3 to 4 | 2.71 (1.34–5.44) | |
| Greater than 4Segment involvement score | 5.27 (2.50–11.07) | |
| Presence of noncalcified atherosclerosis | 1.66 (1.23–2.22) | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Coronary Computed Tomography Angiography in Prediction of First Coronary Events. JAMA. Published 20 January 2026. doi:10.
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