Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study
Authors' conclusion
The FAI Score captures inflammatory risk beyond the current clinical risk stratification and CCTA interpretation, particularly among patients without obstructive CAD.
Study context
- Population
- Consecutive patients undergoing clinically indicated coronary computed tomography angiography (CCTA) in UK National Health Service (NHS) hospitalsFat attenuation index (FAI) analysis n = 3393
- Participants
- 40,091 patients
- Exposure
- Coronary inflammation (FAI Score) and AI-Risk classification vs cardiac mortality and MACE
- No obstructive coronary artery disease (CAD)n = 32,533
- Outcome
- Cardiac mortality or MACE (MI, new onset HF or cardiac death)
- Follow-up
- Median 2.7 years (IQR 1.4-5.3)
Methodological detailsmulticentre, longitudinal, 8 UK hospitals
- Multicentre
- Longitudinal
- 8 UK hospitals
Main finding
As reported in the abstract
7.7 years [6.4-9.1]
FAI Score top quartile, 3 vessels vs FAI Score bottom quartile, 3 vesselsHazard ratio (95% CI)P value
Cardiac mortality
29.8(13.9–63.9)
P < 0.001MACE
12.6(8.5–18.6)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Share of events in patients without obstructive CAD · 2.7 year median follow-up | No obstructive CAD MACE 2857 (66.3%) of the 4307 total MACE · Cardiac deaths 1118 (63.7%) of the 1754 total cardiac deaths | ||
| Cardiac mortality and MACE by AI-Risk classificationAI-Risk very high risk vs AI-Risk low or medium risk · cardiac mortality | 6.75 (CI 5.17–8.82) | P < 0.001 | |
| Cardiac mortality and MACE by AI-Risk classificationAI-Risk very high risk vs AI-Risk low or medium risk · MACE | 4.68 (CI 3.93–5.57) | P < 0.001 |
Cardiac mortality and MACE by AI-Risk classification
- AI-Risk model well calibrated against true events
Original publication
Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study. Lancet. Published 29 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →