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Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry.

Authors
 Yuka Otaki  ;  Heidi Gransar  ;  James K. Min  ;  Daniel S. Berman  ;  Jonathon Leipsic  ;  Yong Jin Kim  ;  Gudrun Feuchtner  ;  Ricardo C. Cury  ;  Allison Dunning  ;  Todd C. Villines  ;  Leslee J. Shaw  ;  Gilbert Raff  ;  Erica Maffei  ;  Philipp Kaufmann  ;  Joerg Hausleiter  ;  Martin Hadamitzky  ;  Augustin Delago  ;  Benjamin J.W. Chow  ;  Kavitha Chinnaiyan  ;  Hyuk Jae Chang  ;  Tracy Q. Callister  ;  Filippo Cademartiri  ;  Matthew J. Budoff  ;  Mouaz Al Mallah  ;  Stephan Achenbach  ;  Fay Y. Lin  ;  Troy Labounty  ;  Damini Dey  ;  Victor Y. Cheng 
Citation
 EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol.16(5) : 490-499, 2015 
Journal Title
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
ISSN
 2047-2404 
Issue Date
2015
MeSH
Adult ; Coronary Angiography* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/epidemiology* ; Coronary Artery Disease/genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Prevalence ; Prospective Studies ; Registries ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Tomography, X-Ray Computed*
Keywords
coronary CT angiography ; coronary artery disease ; coronary risk factors ; young adults
Abstract
OBJECTIVE: Prior studies examining coronary atherosclerosis in the young have been limited by retrospective analyses in small cohorts. We examined the relationship between cardiovascular risk factors (RFs) and prevalence and severity of coronary atherosclerosis in a large, prospective, multinational registry of consecutive young individuals undergoing coronary computerized tomographic angiography (CCTA).
METHOD AND RESULTS: Of 27 125 patients undergoing CCTA, 1635 young (<45 years) individuals without known coronary artery disease (CAD) or coronary anomalies were identified. Coronary plaque was assessed for any CAD, obstructive CAD (≥50% stenosis), and presence of calcified plaque (CP) and non-calcified plaque (NCP). Among 1635 subjects (70% men, age 38 ± 6 years), any CAD, obstructive CAD, CP, and NCP were observed in 19, 4, 5, and 8%, respectively. Compared with women, men demonstrated higher rates of any CAD (21 vs. 12%, P < 0.001), CP (6 vs. 3%, P = 0.01), and NCP (9 vs. 5%, P = 0.008), although no difference was observed for rates of obstructive CAD (5 vs. 4%, P = 0.46). Any CAD, obstructive CAD, and NCP were higher for young individuals with diabetes, hypertension, dyslipidaemia, current smoking, or family history of CAD; while only diabetes and dyslipidaemia were associated with CP. Increasing cardiovascular RFs was associated with a greater prevalence and extent and severity of CAD, with individuals with 0, 1, 2, ≥3 RFs manifesting a dose-response increase in any CAD (P < 0.001, for trend), obstructive CAD (P < 0.001, for trend), NCP (P < 0.001, for trend), and CP (P < 0.001, for trend). In multivariable analysis adjusting for sex and cardiovascular RFs, male sex was the strongest predictor for any CAD (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.43-2.66, P < 0.001), CP (OR = 1.46, 95% CI = 1.08-1.98, P = 0.01), and NCP (OR = 1.33, 95% CI = 1.06-1.67, P = 0.01); family history of CAD was the strongest predictor for obstructive CAD (OR = 2.71, 95% CI = 1.65-4.45, P < 0.001).
CONCLUSION: Any and obstructive CAD is present in 1 in 5 and 1 in 20 young individuals, respectively, with family history associated with the greatest risk of obstructive CAD.
Full Text
http://ehjcimaging.oxfordjournals.org/content/16/5/490
DOI
10.1093/ehjci/jeu281
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/22282913/139129
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