Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study

Abstract This study investigates the long-term prognostic significance of non-obstructive coronary artery disease (CAD) in predicting the risk of all-cause death in a multicenter study. Three hospitals in Wuhan participated in this retrospective, observational, multicenter study of 7320 patients wit...

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Main Authors: Zengfa Huang, Xiaowei Chen, Wanpeng Wang, Xinyu Du, Beibei Cao, Mei Li, Yang Yang, Xi Wang, Jiong Huang, Jinghang Zhu, Xu Zhao, Xiang Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04147-5
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author Zengfa Huang
Xiaowei Chen
Wanpeng Wang
Xinyu Du
Beibei Cao
Mei Li
Yang Yang
Xi Wang
Jiong Huang
Jinghang Zhu
Xu Zhao
Xiang Wang
author_facet Zengfa Huang
Xiaowei Chen
Wanpeng Wang
Xinyu Du
Beibei Cao
Mei Li
Yang Yang
Xi Wang
Jiong Huang
Jinghang Zhu
Xu Zhao
Xiang Wang
author_sort Zengfa Huang
collection DOAJ
description Abstract This study investigates the long-term prognostic significance of non-obstructive coronary artery disease (CAD) in predicting the risk of all-cause death in a multicenter study. Three hospitals in Wuhan participated in this retrospective, observational, multicenter study of 7320 patients with suspected of having CAD and who underwent clinical coronary computed tomography angiography (CTA) from June 2011 to December 2015. According to coronary CTA, the extent of CAD was categorized as non-obstructive, obstructive, and no CAD. The primary outcome was all-cause mortality. A total of 611 patients experienced all-cause mortality with a median duration of 8.0 years (7.2–8.9). The annualized mortality rate was 0.50 (95% CI: 0.43–0.58), 1.31 (95% CI: 1.16–1.47), and 2.18 (95% CI: 1.93–2.46) for the no CAD, non-obstructive CAD, and obstructive CAD, respectively. There was a significant association between the classification and the increased cumulative events, as shown by the Kaplan-Meier survival curve (P < 0.001). The multivariate Cox model showed that the hazard ratios (HR) for predicting all-cause mortality from 1.42 (95% CI: 1.15–1.75, P = 0.001) in non-obstructive CAD to 1.87 (95% CI: 1.50–2.33, P < 0.001) in obstructive CAD compared with no CAD. At 8-year follow-up, patients with non-obstructive CAD detected by coronary CTA had a 1.42-fold increased risk of all-cause mortality compared to patients without evidence of CAD. Thus, these findings suggest that non-obstructive CAD is clinically significant and that further investigation of interventions to improve the prognosis of these patients is warranted.
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spelling doaj-art-0207a020ca5c4b4280f554d71304a9e72025-08-20T02:00:12ZengNature PortfolioScientific Reports2045-23222025-05-011511810.1038/s41598-025-04147-5Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter studyZengfa Huang0Xiaowei Chen1Wanpeng Wang2Xinyu Du3Beibei Cao4Mei Li5Yang Yang6Xi Wang7Jiong Huang8Jinghang Zhu9Xu Zhao10Xiang Wang11Department of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Community Health, Hanyang District Center For Disease Control and PreventionDepartment of Community Health, Hanyang District Center For Disease Control and PreventionDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Radiology, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan UniversityDepartment of RadiologyDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyAbstract This study investigates the long-term prognostic significance of non-obstructive coronary artery disease (CAD) in predicting the risk of all-cause death in a multicenter study. Three hospitals in Wuhan participated in this retrospective, observational, multicenter study of 7320 patients with suspected of having CAD and who underwent clinical coronary computed tomography angiography (CTA) from June 2011 to December 2015. According to coronary CTA, the extent of CAD was categorized as non-obstructive, obstructive, and no CAD. The primary outcome was all-cause mortality. A total of 611 patients experienced all-cause mortality with a median duration of 8.0 years (7.2–8.9). The annualized mortality rate was 0.50 (95% CI: 0.43–0.58), 1.31 (95% CI: 1.16–1.47), and 2.18 (95% CI: 1.93–2.46) for the no CAD, non-obstructive CAD, and obstructive CAD, respectively. There was a significant association between the classification and the increased cumulative events, as shown by the Kaplan-Meier survival curve (P < 0.001). The multivariate Cox model showed that the hazard ratios (HR) for predicting all-cause mortality from 1.42 (95% CI: 1.15–1.75, P = 0.001) in non-obstructive CAD to 1.87 (95% CI: 1.50–2.33, P < 0.001) in obstructive CAD compared with no CAD. At 8-year follow-up, patients with non-obstructive CAD detected by coronary CTA had a 1.42-fold increased risk of all-cause mortality compared to patients without evidence of CAD. Thus, these findings suggest that non-obstructive CAD is clinically significant and that further investigation of interventions to improve the prognosis of these patients is warranted.https://doi.org/10.1038/s41598-025-04147-5Coronary artery diseaseCoronary computed tomography angiographyNon-obstructive coronary artery diseasePrognosis
spellingShingle Zengfa Huang
Xiaowei Chen
Wanpeng Wang
Xinyu Du
Beibei Cao
Mei Li
Yang Yang
Xi Wang
Jiong Huang
Jinghang Zhu
Xu Zhao
Xiang Wang
Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
Scientific Reports
Coronary artery disease
Coronary computed tomography angiography
Non-obstructive coronary artery disease
Prognosis
title Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
title_full Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
title_fullStr Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
title_full_unstemmed Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
title_short Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study
title_sort prognostic value of non obstructive coronary artery disease based on coronary computed tomography angiography in a long term follow up and multicenter study
topic Coronary artery disease
Coronary computed tomography angiography
Non-obstructive coronary artery disease
Prognosis
url https://doi.org/10.1038/s41598-025-04147-5
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