title: Prognostic value of Morise clinical score, calcium score and computed tomography coronary angiography in patients with suspected or known coronary artery disease.
abstract: OBJECTIVE
  Our aim was to determine the prognostic value of computed tomography coronary angiography (CTCA), coronary artery calcium scoring (CACS) and Morise clinical score in patients with known or suspected coronary artery disease (CAD).
  
  
  METHODS
  A total of 722 patients (480 men; 62.7±10.9 years) who were referred for further cardiac evaluation underwent CACS and contrast-enhanced CTCA to evaluate the presence and severity of CAD. Of these, 511 (71%) patients were without previous history of CAD. Patients were stratified according to the Morise clinical score (low, intermediate, high), to CACS (0-10, 11-100, 101-400, 401-1,000, >1,000) and to CTCA (absence of CAD, nonsignificant CAD, obstructive CAD). Patients were followed up for the occurrence of major events: cardiac death, nonfatal myocardial infarction, unstable angina and revascularisation.
  
  
  RESULTS
  Significant CAD (>50% luminal narrowing) was detected in 260 (36%) patients; nonsignificant CAD (<50% luminal narrowing) in 250 (35%) and absence of CAD in 212 (29%). During a mean follow-up of 20±4 months, 116 events (21 hard) occurred. In patients with normal coronary arteries on CTCA, the major event rate was 0% vs. 1.7% in patients with nonsignificant CAD and 7.3% in patients with significant CAD (p<0.0001). Three hard events (14%) occurred in patients with CACS≤100 and two (9.5%) in patients with intermediate Morise score; one revascularisation was observed in a patient with low Morise score. At multivariate analysis, diabetes, obstructive CAD and CACS >1,000 were significant predictors of events (p<0.05).
  
  
  CONCLUSIONS
  An excellent prognosis was noted in patients with a normal CTCA (0% event rate). CACS ≤100 and low-intermediate Morise score did not exclude the possibility of events at follow-up.
authors: Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy.
authors: E
authors: E
authors: Maffei
authors: S
authors: S
authors: Seitun
authors: A
authors: A
authors: Palumbo
authors: C
authors: C
authors: Martini
authors: E
authors: E
authors: Emiliano
authors: A
authors: A
authors: Cuttone
authors: A
authors: A
authors: Aldrovandi
authors: R
authors: R
authors: Malagò
authors: L
authors: L
authors: La Grutta
authors: M
authors: M
authors: Midiri
authors: C
authors: C
authors: Tedeschi
authors: R
authors: R
authors: De Rosa
authors: O
authors: O
authors: Catalano
authors: A
authors: A
authors: Weustink
authors: N
authors: N
authors: Mollet
authors: F
authors: F
authors: Cademartiri
mesh_terms: D000368:Aged; D000465:Algorithms; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000401:mortality; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed