Extract

This editorial refers to ‘Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography: a Danish multicentre cohort study’, by L.H. Neilsen et al., on page 413.

Somewhere, something incredible is waiting to be known

Carl Sagan

The last decade has seen a veritable explosion of data evaluating and establishing the prognostic value of coronary computed tomography angiography (CTA) in asymptomatic and symptomatic patients with suspected coronary artery disease (CAD).1–3 These data have been essential to move coronary CTA from simply a diagnostic test to one that is rich in prognostic information. The first manuscripts were, however, quite limited in their scope, emanating from single centres and therefore fraught with all of the inclusion and ascertainment biases that are inherent in retrospective single-centre analyses.4,5 Building upon these initial experiences, large registries were developed, led by the CONFIRM registry and James Min which have served to deepen our understanding of the relationship of baseline cardiovascular risk, symptoms, and coronary CT findings and downstream major adverse cardiovascular events (Figure 1).2 These registries have confirmed that a worsening extent and severity of CAD on CTA results in increased relative and absolute risk to the patient across gender and a whole host of other subanalyses.

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