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Clinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry

DC FieldValueLanguage
dc.contributor.author장혁재-
dc.date.accessioned2020-09-28T11:10:46Z-
dc.date.available2020-09-28T11:10:46Z-
dc.date.issued2020-05-
dc.identifier.issn2047-2404-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/179182-
dc.description.abstractAims: In patients without obstructive coronary artery disease (CAD), we examined the prognostic value of risk factors and atherosclerotic extent. Methods and results: Patients from the long-term CONFIRM registry without prior CAD and without obstructive (≥50%) stenosis were included. Within the groups of normal coronary computed tomography angiography (CCTA) (N = 1849) and non-obstructive CAD (N = 1698), the prognostic value of traditional clinical risk factors and atherosclerotic extent (segment involvement score, SIS) was assessed with Cox models. Major adverse cardiac events (MACE) were defined as all-cause mortality, non-fatal myocardial infarction, or late revascularization. In total, 3547 patients were included (age 57.9 ± 12.1 years, 57.8% male), experiencing 460 MACE during 5.4 years of follow-up. Age, body mass index, hypertension, and diabetes were the clinical variables associated with increased MACE risk, but the magnitude of risk was higher for CCTA defined atherosclerotic extent; adjusted hazard ratio (HR) for SIS >5 was 3.4 (95% confidence interval [CI] 2.3-4.9) while HR for diabetes and hypertension were 1.7 (95% CI 1.3-2.2) and 1.4 (95% CI 1.1-1.7), respectively. Exclusion of revascularization as endpoint did not modify the results. In normal CCTA, presence of ≥1 traditional risk factors did not worsen prognosis (log-rank P = 0.248), while it did in non-obstructive CAD (log-rank P = 0.025). Adjusted for SIS, hypertension and diabetes predicted MACE risk in non-obstructive CAD, while diabetes did not increase risk in absence of CAD (P-interaction = 0.004). Conclusion: Among patients without obstructive CAD, the extent of CAD provides more prognostic information for MACE than traditional cardiovascular risk factors. An interaction was observed between risk factors and CAD burden, suggesting synergistic effects of both.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherOxford University Press-
dc.relation.isPartOfEUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleClinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorAlexander R van Rosendael-
dc.contributor.googleauthorA Maxim Bax-
dc.contributor.googleauthorJeff M Smit-
dc.contributor.googleauthorInge J van den Hoogen-
dc.contributor.googleauthorXiaoyue Ma-
dc.contributor.googleauthorSubhi Al'Aref-
dc.contributor.googleauthorStephan Achenbach-
dc.contributor.googleauthorMouaz H Al-Mallah-
dc.contributor.googleauthorDaniele Andreini-
dc.contributor.googleauthorDaniel S Berman-
dc.contributor.googleauthorMatthew J Budoff-
dc.contributor.googleauthorFilippo Cademartiri-
dc.contributor.googleauthorTracy Q Callister-
dc.contributor.googleauthorHyuk-Jae Chang-
dc.contributor.googleauthorKavitha Chinnaiyan-
dc.contributor.googleauthorBenjamin J W Chow-
dc.contributor.googleauthorRicardo C Cury-
dc.contributor.googleauthorAugustin DeLago-
dc.contributor.googleauthorGudrun Feuchtner-
dc.contributor.googleauthorMartin Hadamitzky-
dc.contributor.googleauthorJoerg Hausleiter-
dc.contributor.googleauthorPhilipp A Kaufmann-
dc.contributor.googleauthorYong-Jin Kim-
dc.contributor.googleauthorJonathon A Leipsic-
dc.contributor.googleauthorErica Maffei-
dc.contributor.googleauthorHugo Marques-
dc.contributor.googleauthorPedro de Araújo Gonçalves-
dc.contributor.googleauthorGianluca Pontone-
dc.contributor.googleauthorGilbert L Raff-
dc.contributor.googleauthorRonen Rubinshtein-
dc.contributor.googleauthorTodd C Villines-
dc.contributor.googleauthorHeidi Gransar-
dc.contributor.googleauthorYao Lu-
dc.contributor.googleauthorJessica M Peña-
dc.contributor.googleauthorFay Y Lin-
dc.contributor.googleauthorLeslee J Shaw-
dc.contributor.googleauthorJames K Min-
dc.contributor.googleauthorJeroen J Bax-
dc.identifier.doi10.1093/ehjci/jez322-
dc.contributor.localIdA03490-
dc.relation.journalcodeJ00806-
dc.identifier.eissn2047-2412-
dc.identifier.pmid32065624-
dc.subject.keywordatherosclerosis-
dc.subject.keywordcoronary computed tomography angiography-
dc.subject.keywordimaging-
dc.subject.keywordpreventive cardiology-
dc.subject.keywordrisk stratification-
dc.contributor.alternativeNameChang, Hyuck Jae-
dc.contributor.affiliatedAuthor장혁재-
dc.citation.volume21-
dc.citation.number5-
dc.citation.startPage479-
dc.citation.endPage488-
dc.identifier.bibliographicCitationEUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol.21(5) : 479-488, 2020-05-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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