Author + information
- Martin Hadamitzky, MD∗ ()
- ↵∗Institut für Radiologie und Nuklearmedizin, Deutsches Herzzentrum, Lazarettstrasse 36, 80636 Munich, Germany
We thank Dr. Gill and colleagues for their interest in our study, whose main focus was to present the long-term prognostic value of coronary computed tomography angiography in a manner that allows easy implementation in clinical practice. Most reporting scores yielded comparable results without significant differences. Besides the most established coronary artery disease (CAD) severity score, we therefore chose the CAD-RADS (Coronary Artery Disease-Reporting and Data System) and segment involvement scores to emphasize the degree of stenosis and extent of CAD, respectively. The CT-Leaman score in particular did not outperform the segment involvement score in our population, with a C-index of 0.704 compared with 0.712 for the segment involvement score (p = 0.13, both combined with Morise score). A subgroup analysis for patients with nonobstructed CAD was clearly beyond the scope of the manuscript, but we thank our colleagues for this valuable suggestion of a further analysis.
The question of how to correct for clinical risk has been fiercely discussed since our first publication on this topic (1). Because the Framingham score was criticized at that time (2) and the use of all 7 clinical risk factors could lead to overfitting, we have used the Morise score since then. We agree with Gill and colleagues that it is not optimal, but out of the established scores it is the clinically most appropriate one in our opinion.
Please note: Dr. Hadamitzky has reported that he has no relationships relevant to the contents of this paper to disclose.
- 2019 American College of Cardiology Foundation
- Hadamitzky M.,
- Freißmuth B.,
- Meyer T.,
- et al.
- Rassi A.