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Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease.

DC Field Value Language
dc.contributor.author장혁재-
dc.date.accessioned2014-12-20T17:18:16Z-
dc.date.available2014-12-20T17:18:16Z-
dc.date.issued2011-
dc.identifier.issn0735-1097-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/94346-
dc.description.abstractOBJECTIVES: We examined mortality in relation to coronary artery disease (CAD) as assessed by ≥64-detector row coronary computed tomography angiography (CCTA). BACKGROUND: Although CCTA has demonstrated high diagnostic performance for detection and exclusion of obstructive CAD, the prognostic findings of CAD by CCTA have not, to date, been examined for age- and sex-specific outcomes. METHODS: We evaluated a consecutive cohort of 24,775 patients undergoing ≥64-detector row CCTA between 2005 and 2009 without known CAD who met inclusion criteria. In these patients, CAD by CCTA was defined as none (0% stenosis), mild (1% to 49% stenosis), moderate (50% to 69% stenosis), or severe (≥70% stenosis). CAD severity was judged on a per-patient, per-vessel, and per-segment basis. Time to mortality was estimated using multivariable Cox proportional hazards models. RESULTS: At a 2.3 ± 1.1-year follow-up, 404 deaths had occurred. In risk-adjusted analysis, both per-patient obstructive (hazard ratio [HR]: 2.60; 95% confidence interval [CI]: 1.94 to 3.49; p < 0.0001) and nonobstructive (HR: 1.60; 95% CI: 1.18 to 2.16; p = 0.002) CAD conferred increased risk of mortality compared with patients without evident CAD. Incident mortality was associated with a dose-response relationship to the number of coronary vessels exhibiting obstructive CAD, with increasing risk observed for nonobstructive (HR: 1.62; 95% CI: 1.20 to 2.19; p = 0.002), obstructive 1-vessel (HR: 2.00; 95% CI: 1.43 to 2.82; p < 0.0001), 2-vessel (HR: 2.92; 95% CI: 2.00 to 4.25; p < 0.0001), or 3-vessel or left main (HR: 3.70; 95% CI: 2.58 to 5.29; p < 0.0001) CAD. Importantly, the absence of CAD by CCTA was associated with a low rate of incident death (annualized death rate: 0.28%). When stratified by age <65 years versus ≥65 years, younger patients experienced higher hazards for death for 2-vessel (HR: 4.00; 95% CI: 2.16 to 7.40; p < 0.0001 vs. HR: 2.46; 95% CI: 1.51 to 4.02; p = 0.0003) and 3-vessel (HR: 6.19; 95% CI: 3.43 to 11.2; p < 0.0001 vs. HR: 3.10; 95% CI: 1.95 to 4.92; p < 0.0001) CAD. The relative hazard for 3-vessel CAD (HR: 4.21; 95% CI: 2.47 to 7.18; p < 0.0001 vs. HR: 3.27; 95% CI: 1.96 to 5.45; p < 0.0001) was higher for women as compared with men. CONCLUSIONS: Among individuals without known CAD, nonobstructive and obstructive CAD by CCTA are associated with higher rates of mortality, with risk profiles differing for age and sex. Importantly, absence of CAD is associated with a very favorable prognosis.-
dc.description.statementOfResponsibilityopen-
dc.format.extent849~860-
dc.relation.isPartOfJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAgeFactors-
dc.subject.MESHAged-
dc.subject.MESHCoronaryAngiography*-
dc.subject.MESHCoronaryArteryDisease/diagnostic imaging-
dc.subject.MESHCoronaryArteryDisease/mortality*-
dc.subject.MESHCoronaryStenosis/diagnostic imaging-
dc.subject.MESHCoronaryStenosis/mortality*-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHProspective Studies-
dc.subject.MESHRegistries-
dc.subject.MESHRiskAssessment-
dc.subject.MESHSeverity of Illness Index-
dc.subject.MESHSex Factors-
dc.subject.MESHTomography, X-RayComputed-
dc.titleAge- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorJames K. Min-
dc.contributor.googleauthorAllison Dunning-
dc.contributor.googleauthorFay Y. Lin-
dc.contributor.googleauthorStephan Achenbach-
dc.contributor.googleauthorMouaz Al-Mallah-
dc.contributor.googleauthorMatthew J. Budoff-
dc.contributor.googleauthorFilippo Cademartiri-
dc.contributor.googleauthorTracy Q. Callister-
dc.contributor.googleauthorHyuk-Jae Chang-
dc.contributor.googleauthorVictor Cheng-
dc.contributor.googleauthorKavitha Chinnaiyan-
dc.contributor.googleauthorBenjamin J.W. Chow-
dc.contributor.googleauthorAugustin Delago-
dc.contributor.googleauthorMartin Hadamitzky-
dc.contributor.googleauthorJoerg Hausleiter-
dc.contributor.googleauthorPhilipp Kaufmann-
dc.contributor.googleauthorErica Maffei-
dc.contributor.googleauthorGilbert Raff-
dc.contributor.googleauthorLeslee J. Shaw-
dc.contributor.googleauthorTodd Villines-
dc.contributor.googleauthorDaniel S. Berman-
dc.contributor.googleauthorCONFIRM Investigators-
dc.identifier.doi10.1016/j.jacc.2011.02.074-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03490-
dc.relation.journalcodeJ01770-
dc.identifier.eissn1558-3597-
dc.identifier.pmid21835321-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0735109711019541-
dc.subject.keywordatherosclerosis-
dc.subject.keywordcomputed tomography-
dc.subject.keywordcoronary disease-
dc.subject.keywordnonobstructive-
dc.subject.keywordprognosis-
dc.contributor.alternativeNameChang, Hyuck Jae-
dc.contributor.affiliatedAuthorChang, Hyuck Jae-
dc.rights.accessRightsnot free-
dc.citation.volume58-
dc.citation.number8-
dc.citation.startPage849-
dc.citation.endPage860-
dc.identifier.bibliographicCitationJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.58(8) : 849-860, 2011-
dc.identifier.rimsid27561-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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