Prognostic Impact of Coronary Computed Tomographic Angiography (CCTA) According to Standard Cardiovascular Modifiable Risk Factors
Authors' conclusion
Across CCTA-defined stenosis categories, SMuRF burden provides incremental prognostic information beyond anatomic disease severity, supporting its integration into CCTA-based risk stratification and personalized preventive management.
Study context
- Population
- Patients without prior CAD who underwent clinically indicated CCTAmean age 64 ± 14 years, 53% men
- Participants
- 29,840 patients
- Comparison
- Whether SMuRF burden modifies the prognostic value of the different coronary artery disease (CAD) categories on CCTA
- Outcome
- all-cause mortality or myocardial infarction (MI)
- Follow-up
- Median 2 years
Main finding
As reported in the abstract
each 1-SMuRF increaseHazard ratio (95% CI)
Absent CAD; adjusted
1.41(1.27–1.56)
Nonobstructive CAD; adjusted
1.26(1.17–1.35)
Obstructive CAD; adjusted
1.29(1.19–1.40)
Each 1-SMuRF increase, as printed
- Patients experienced death or MI
- 2,030 patients (7%)
- Across all CAD categories, higher SMuRF burden associated with higher cumulative incidence and incidence rates
- P < 0.001
Further findings
CAD distribution
| Outcome | Absent CAD | Nonobstructive CAD | Obstructive CAD |
|---|---|---|---|
| Incidence rates of death or MI per 1,000 person-years across SMuRF categories 0 to 4 | incidence rate 10 to 74 per 1,000 person-years | — not stated in the abstract | incidence rate 35 to 75 per 1,000 person-years |
— not stated in the abstract
- Incidence rates of death or MI per 1,000 person-years across SMuRF categories 0 to 4: P < 0.001
Prognostic discrimination adding SMuRF burden to age, sex, body mass index, and CAD severity
- C-index
- 0.653-0.673
- P < 0.001
Original publication
Prognostic Impact of CCTA According to Standard Cardiovascular Modifiable Risk Factors. JACC Adv. Published 21 September 2026. doi:10.
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