Cited 18 times in
Risk stratification of non-obstructive coronary artery disease for guidance of preventive medical therapy
DC Field | Value | Language |
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dc.contributor.author | 장혁재 | - |
dc.date.accessioned | 2019-12-18T00:37:12Z | - |
dc.date.available | 2019-12-18T00:37:12Z | - |
dc.date.issued | 2019 | - |
dc.identifier.issn | 0021-9150 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/173140 | - |
dc.description.abstract | BACKGROUND AND AIMS: Given the potential benefit of medical therapy in patients with non-obstructive coronary artery disease (CAD), there is a need for risk stratification and treatment strategy for these patients. We aimed to develop a risk prediction model for non-obstructive CAD patients for risk stratification and guidance of statin and aspirin therapy. METHODS: From a cohort of consecutive patients who underwent coronary computed tomography angiography (CCTA) (n = 25,087), we identified patients with non-obstructive CAD of 1-49% diameter-stenosis (n = 6243) and developed a risk prediction model for 5-year occurrence of a composite of all-cause mortality, myocardial infarction, and late coronary revascularization using a derivation cohort (n = 4391). RESULTS: Age, sex, hypertension, diabetes, anemia, C-reactive protein, and the extent of non-obstructive CAD were incorporated in the prediction model (risk score 0-13, C-index = 0.716). Patients were categorized into 4 groups; risk score of 0-3 (low-risk), 4-6 (intermediate-risk), 7-9 (high-risk), and ≥10 (very high-risk). Patients with very high-risk demonstrated unfavorable outcome comparable to patients with obstructive CAD. The low-risk group exhibited favorable outcome similar to those with no CAD. While statin therapy was associated with better outcomes in high- or very high-risk group (hazard ratio, 0.62; 95% confidence interval, 0.39-0.96; p = 0.033), aspirin use was associated with an increased risk in low-risk group (hazard ratio, 2.57; 95% confidence interval, 1.34-4.90; p = 0.004). CONCLUSIONS: A dedicated risk scoring system for non-obstructive CAD using clinical factors and CCTA findings accurately predicted prognosis. According to our risk prediction model, statin therapy can be beneficial for high-risk patients, whereas aspirin can be harmful for low-risk patients. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | ATHEROSCLEROSIS | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Risk stratification of non-obstructive coronary artery disease for guidance of preventive medical therapy | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | In-Chang Hwang | - |
dc.contributor.googleauthor | Heesun Lee | - |
dc.contributor.googleauthor | Yeonyee E. Yoon | - |
dc.contributor.googleauthor | In-Soon Choi | - |
dc.contributor.googleauthor | Hack-Lyoung Kim | - |
dc.contributor.googleauthor | Hyuk-Jae Chang | - |
dc.contributor.googleauthor | Ja Youn Lee | - |
dc.contributor.googleauthor | Jin A. Choi | - |
dc.contributor.googleauthor | Hyo Jeong Kim | - |
dc.contributor.googleauthor | Goo-Yeong Cho | - |
dc.contributor.googleauthor | Jun-Bean Park | - |
dc.contributor.googleauthor | Seung-Pyo Lee | - |
dc.contributor.googleauthor | Hyung-Kwan Kim | - |
dc.contributor.googleauthor | Yong-Jin Kim | - |
dc.contributor.googleauthor | Dae-Won Sohn | - |
dc.identifier.doi | 10.1016/j.atherosclerosis.2019.09.018 | - |
dc.contributor.localId | A03490 | - |
dc.relation.journalcode | J00260 | - |
dc.identifier.eissn | 1879-1484 | - |
dc.identifier.pmid | 31586872 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S0021915019315059 | - |
dc.subject.keyword | Aspirin | - |
dc.subject.keyword | Coronary CT angiography | - |
dc.subject.keyword | Non-obstructive coronary artery disease | - |
dc.subject.keyword | Risk stratification | - |
dc.subject.keyword | Statin | - |
dc.contributor.alternativeName | Chang, Hyuck Jae | - |
dc.contributor.affiliatedAuthor | 장혁재 | - |
dc.citation.volume | 290 | - |
dc.citation.startPage | 66 | - |
dc.citation.endPage | 73 | - |
dc.identifier.bibliographicCitation | ATHEROSCLEROSIS, Vol.290 : 66-73, 2019 | - |
dc.identifier.rimsid | 63619 | - |
dc.type.rims | ART | - |
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