3 497

Cited 25 times in

Cardiovascular Risk among Stable Individuals Suspected of Having Coronary Artery Disease with No Modifiable Risk Factors: Results from an International Multicenter Study of 5262 Patients

Authors
 Jonathon Leipsic  ;  Carolyn M. Taylor  ;  Gilat Grunau  ;  Brett G. Heilbron  ;  G. B. John Mancini  ;  Stephan Achenbach  ;  Mouaz Al-Mallah  ;  Daniel S. Berman  ;  Matthew J. Budoff  ;  Filippo Cademartiri  ;  Tracy Q. Callister  ;  Hyuk-Jae Chang  ;  Victor Y. Cheng  ;  Kavitha Chinnaiyan  ;  Benjamin J. W. Chow  ;  Augustin Delago  ;  Martin Hadamitzky  ;  Joerg Hausleiter  ;  Ricardo Cury  ;  Gudrun Feuchtner  ;  Yong-Jin Kim  ;  Philipp A. Kaufmann  ;  Fay Y. Lin  ;  Erica Maffei  ;  Gilbert Raff  ;  Leslee J. Shaw  ;  Todd C. Villines  ;  James K. Min 
Citation
 RADIOLOGY, Vol.267(3) : 718-726, 2013 
Journal Title
RADIOLOGY
ISSN
 0033-8419 
Issue Date
2013
MeSH
Chi-Square Distribution ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/genetics ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Registries ; Risk Factors ; Severity of Illness Index ; Tomography, X-Ray Computed*
Keywords
Chi-Square Distribution ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/genetics ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Prospective Studies ; Registries ; Risk Factors ; Severity of Illness Index ; Tomography, X-Ray Computed*
Abstract
PURPOSE:
To assess the prevalence, extent, severity, and risk of coronary artery disease (CAD) in patients suspected of having CAD but with no medically modifiable risk factors.
MATERIALS AND METHODS:
Institutional review board approval or waiver of consent was obtained at each center. This study was HIPAA compliant. From an international multicenter cohort study of 27 125 subjects undergoing coronary computed tomographic (CT) angiography from 12 centers, 5262 patients without known CAD and without modifiable risk factors were identified. CAD severity was defined as none (0%), mild (1%-49%), or obstructive (≥ 50%) on a per-patient, per-vessel, and per-segment basis. CAD presence, extent, and severity were related to incidence of major adverse cardiovascular event (MACE) by using Cox proportional hazards models.
RESULTS:
At a mean follow-up of 2.3 years ± 1.2 (standard deviation), MACE occurred in 106 patients. CAD was common for nonobstructive (n = 1452, 27%) and obstructive (n = 629, 12%) CAD. In risk-adjusted analysis, per-patient obstructive CAD (hazard ratio [HR], 6.64; 95% confidence interval [CI]: 3.68, 12.00; P ≤ .001) was related to MACE. MACE was associated with a dose-response relationship to the number of vessels exhibiting obstructive CAD, increasing risk for obstructive one-vessel (HR, 6.11; 95% CI: 3.22, 11.6; P ≤ .001), two-vessel (HR, 5.86; 95% CI: 2.75, 12.5; P ≤ .0001), or three-vessel or left main (HR, 11.69; 95% CI: 5.38, 25.4; P ≤ .001) CAD. The increased hazard for MACE of obstructive disease holds true for symptomatic (HR, 11.9; 95% CI: 4.81, 29.6; P ≤ .001) and asymptomatic (HR, 6.3; 95% CI: 2.4, 16.7; P ≤ .001) patients. No CAD at coronary CT angiography was associated with a low annualized MACE rate: 0.31% versus 2.06% with obstructive disease.
CONCLUSION:
Among individuals suspected of having CAD but without modifiable risk factors, CAD is common, with significantly increased hazards for MACE and mortality.
Full Text
http://pubs.rsna.org/doi/abs/10.1148/radiol.13121669?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
10.1148/radiol.13121669
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87125
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links