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Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry.

DC Field Value Language
dc.contributor.author장혁재-
dc.date.accessioned2014-12-20T17:43:36Z-
dc.date.available2014-12-20T17:43:36Z-
dc.date.issued2011-
dc.identifier.issn0735-1097-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/95146-
dc.description.abstractOBJECTIVES: The purpose of this study was to describe the prevalence and severity of coronary artery disease (CAD) in relation to prognosis in symptomatic patients without coronary artery calcification (CAC) undergoing coronary computed tomography angiography (CCTA). BACKGROUND: The frequency and clinical relevance of CAD in patients without CAC are unclear. METHODS: We identified 10,037 symptomatic patients without CAD who underwent concomitant CCTA and CAC scoring. CAD was assessed as <50%, ≥50%, and ≥70% stenosis. All-cause mortality and the composite endpoint of mortality, myocardial infarction, or late coronary revascularization (≥90 days after CCTA) were assessed. RESULTS: Mean age was 57 years, 56% were men, and 51% had a CAC score of 0. Among patients with a CAC score of 0, 84% had no CAD, 13% had nonobstructive stenosis, and 3.5% had ≥50% stenosis (1.4% had ≥70% stenosis) on CCTA. A CAC score >0 had a sensitivity, specificity, and negative and positive predictive values for stenosis ≥50% of 89%, 59%, 96%, and 29%, respectively. During a median of 2.1 years, there was no difference in mortality among patients with a CAC score of 0 irrespective of obstructive CAD. Among 8,907 patients with follow-up for the composite endpoint, 3.9% with a CAC score of 0 and ≥50% stenosis experienced an event (hazard ratio: 5.7; 95% confidence interval: 2.5 to 13.1; p < 0.001) compared with 0.8% of patients with a CAC score of 0 and no obstructive CAD. Receiver-operator characteristic curve analysis demonstrated that the CAC score did not add incremental prognostic information compared with CAD extent on CCTA for the composite endpoint (CCTA area under the curve = 0.825; CAC + CCTA area under the curve = 0.826; p = 0.84). CONCLUSIONS: In symptomatic patients with a CAC score of 0, obstructive CAD is possible and is associated with increased cardiovascular events. CAC scoring did not add incremental prognostic information to CCTA.-
dc.description.statementOfResponsibilityopen-
dc.format.extent2533~2540-
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.MESHCalcinosis/complications-
dc.subject.MESHCalcinosis/diagnostic imaging*-
dc.subject.MESHCoronary Angiography*-
dc.subject.MESHCoronary Artery Disease/complications-
dc.subject.MESHCoronary Artery Disease/diagnostic imaging*-
dc.subject.MESHCoronary Artery Disease/mortality-
dc.subject.MESHCoronary Artery Disease/therapy-
dc.subject.MESHCoronary Stenosis/complications-
dc.subject.MESHCoronary Stenosis/diagnostic imaging*-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMyocardial Infarction/etiology-
dc.subject.MESHMyocardial Revascularization-
dc.subject.MESHPrognosis-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRegistries-
dc.subject.MESHRisk Factors-
dc.subject.MESHSensitivity and Specificity-
dc.subject.MESHTomography, X-Ray Computed*-
dc.titlePrevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorTodd C. Villines-
dc.contributor.googleauthorEdward A. Hulten-
dc.contributor.googleauthorLeslee J. Shaw-
dc.contributor.googleauthorManju Goyal-
dc.contributor.googleauthorAllison Dunning-
dc.contributor.googleauthorStephan Achenbach-
dc.contributor.googleauthorMouaz Al-Mallah-
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.googleauthorVictor Y. Cheng-
dc.contributor.googleauthorKavitha Chinnaiyan-
dc.contributor.googleauthorBenjamin J.W. Chow-
dc.contributor.googleauthorAugustin Delago-
dc.contributor.googleauthorMartin Hadamitzky-
dc.contributor.googleauthorJörg Hausleiter-
dc.contributor.googleauthorPhilipp Kaufmann-
dc.contributor.googleauthorFay Y. Lin-
dc.contributor.googleauthorErica Maffei-
dc.contributor.googleauthorGilbert L. Raff-
dc.identifier.doi10.1016/j.jacc.2011.10.851-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03490-
dc.relation.journalcodeJ01770-
dc.identifier.eissn1558-3597-
dc.identifier.pmid22079127-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0735109711045359-
dc.subject.keywordcomputed tomography-
dc.subject.keywordcoronary artery disease-
dc.subject.keywordcoronary calcium score-
dc.subject.keywordcoronary computed tomography angiography-
dc.subject.keywordprognosis-
dc.contributor.alternativeNameChang, Hyuck Jae-
dc.contributor.affiliatedAuthorChang, Hyuck Jae-
dc.rights.accessRightsnot free-
dc.citation.volume58-
dc.citation.number24-
dc.citation.startPage2533-
dc.citation.endPage2540-
dc.identifier.bibliographicCitationJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.58(24) : 2533-2540, 2011-
dc.identifier.rimsid28129-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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