Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2755
Título: Sex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events: The CONFIRM Long-Term Registry
Autor: Schulman-Marcus, J
Hartaigh, B
Gransar, H
Lin, F
Valenti, V
Cho, I
Berman, D
Callister, T
DeLago, A
Hadamitzky, M
Hausleiter, J
Al-Mallah, M
Budoff, M
Kaufmann, P
Achenbach, S
Raff, G
Chinnaiyan, K
Cademartiri, F
Maffei, E
Villines, T
Kim, Y
Leipsic, J
Feuchtner, G
Rubinshtein, R
Pontone, G
Andreini, D
Marques, H
Shaw, L
Min, J
Palavras-chave: Aged
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Stenosis
Disease Progression
Follow-Up Studies
Kaplan-Meier Estimate
Middle Aged
Multidetector Computed Tomography
Myocardial Infarction
North America
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Republic of Korea
Risk Factors
Severity of Illness Index
Sex Distribution
Sex Factors
Time Factors
Coronary Vessels
Plaque, Atherosclerotic
Data: Abr-2016
Editora: Elsevier
Citação: JACC Cardiovasc Imaging. 2016 Apr;9(4):364-372
Resumo: OBJECTIVES: The purpose of this study was to examine sex-specific associations, if any, between per-vessel coronary artery disease (CAD) extent and the risk of major adverse cardiovascular events (MACE) over a 5-year study duration. BACKGROUND: The presence and extent of CAD diagnosed by coronary computed tomography angiography (CTA) is associated with increased short-term mortality and MACE. Nevertheless, some uncertainty remains regarding the influence of sex on these findings. METHODS: 5,632 patients (mean age 60.2 ± 11.8 years, 36.5% women) from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry were followed for 5 years. Obstructive CAD was defined as ≥50% luminal stenosis in a coronary vessel. Using Cox proportional hazards models, we calculated the hazard ratio (HR) for incident MACE among women and men, defined as death or myocardial infarction. RESULTS: Obstructive CAD was more prevalent in men (42% vs. 26%; p < 0.001), whereas women were more likely to have normal coronary arteries (43% vs. 27%; p < 0.001). There were a total of 798 incident MACE events. After adjustment, there was a strong association between increased MACE risk and nonobstructive CAD (HR: 2.16 for women, 2.56 for men; p < 0.001 for both), obstructive 1-vessel CAD (HR: 3.69 and 2.66; p < 0.001), 2-vessel CAD (HR: 3.92 and 3.55; p < 0.001), and 3-vessel/left main CAD (HR: 5.94 and 4.44; p < 0.001). Further exploratory analyses of atherosclerotic burden did not identify sex-specific patterns predictive of MACE. CONCLUSIONS: In a large prospective coronary CTA cohort followed long-term, we did not observe an interaction of sex for the association between MACE risk and increased per-vessel extent of obstructive CAD. These findings highlight the persistent prognostic significance of anatomic CAD subsets as detected by coronary CTA for the risk of MACE in both women and men.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2755
DOI: 10.1016/j.jcmg.2016.02.010
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