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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prognostic significance of calcified plaque among symptomatic patients with nonobstructive coronary artery disease
Journal of Nuclear Cardiology, Volume 21, No. 3, Year 2014
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Description
Background. Coronary artery calcium (CAC) is a well-established predictor of clinical outcomes for population screening. Limited evidence is available as to its predictive value in symptomatic patients without obstructive coronary artery disease (CAD). The aim of the current study was to assess the prognostic value of CAC scores among symptomatic patients with nonobstructive CAD. Methods. From the COronary Computed Tomographic Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry, 7,200 symptomatic patients with nonobstructive CAD (<50% coronary stenosis) on coronary-computed tomographic angiography were prospectively enrolled and followed for a median of 2.1 years. Patients were categorized as without (0% stenosis) or with (>0% but <50% coronary stenosis) a luminal stenosis. CAC scores were calculated using the Agatston method. Univariable and multivariable Cox proportional hazard models were employed to estimate all-cause mortality and/or myocardial infarction (MI). Four-year death and death or MI rates were 1.9% and 3.3%. Results. Of the 4,380 patients with no luminal stenosis, 86% had CAC scores of <10 while those with a luminal stenosis had more prevalent and extensive CAC with 31.9% having a CAC score of ≥100. Among patients with no luminal stenosis, CAC was not predictive of all-cause mortality (P = .44). However, among patients with a luminal stenosis, 4-year mortality rates ranged from 0.8% to 9.8% for CAC scores of 0 to ≥400 (P < .0001). The mortality hazard was 6.0 (P = .004) and 13.3 (P < .0001) for patients with a CAC score of 100-399 and ≥400. In patients with a luminal stenosis, CAC remained independently predictive in all-cause mortality (P < .0001) and death or MI (P < .0001) in multivariable models containing CAD risk factors and presenting symptoms. Conclusions. CAC allows for the identification of those at an increased hazard for death or MI in symptomatic patients with nonobstructive disease. From the CONFIRM registry, the extent of CAC was an independent estimator of long-term prognosis among symptomatic patients with luminal stenosis and may further define risk and guide preventive strategies in patients with nonobstructive CAD. © 2014 American Society of Nuclear Cardiology.
Authors & Co-Authors
Shah, Sana
United States, Atlanta
Emory University School of Medicine
Bellam, Naveen
United States, Atlanta
Emory University School of Medicine
Leipsic, Jonathon Avrom
Canada, Vancouver
The University of British Columbia
Berman, Daniel S.
United States, Los Angeles
Cedars-sinai Medical Center
Erdmann, Jeanette Ali
United States, Atlanta
Emory University School of Medicine
Hausleiter, Jörg
Germany, Munich
Technische Universität München
Achenbach, Stephan S.
Germany, Giessen
Justus-liebig-universität Gießen
Al-Mallah, Mouaz Husayn
Saudi Arabia, Riyadh
King Abdulaziz Medical City - Riyadh
Budoff, M. Jay
United States, Torrance
Harbor-ucla Medical Center
Cademartiri, Filippo
Italy, Bali
Giovanni Xxiii Hospital
Callister, Tracy Q.
United States, Nashville
Tennessee Heart and Vascular Institute
Chang, Hyukjae
South Korea, Seoul
Severance Cardiovascular Hospital
Chow, Benjamin J.W.
Canada, Ottawa
Institut de Cardiologie de L'université D'ottawa
Cury, Ricardo Caldeira
United States, Miami
Baptist Hospital Miami
DeLago, Augustin J.
United States, Albany
Capital Cardiology Associates
Dunning, Allison L.
United States, New York
New York Presbyterian Hospital
Feuchtner, Gudrun Maria
Austria, Innsbruck
Medizinische Universitat Innsbruck
Hadamitzky, Martin
Germany, Munich
Technische Universität München
Karlsberg, Ronald P.
United States, Oakland
Cardiovascular Consultants Medical Group, Inc.
Kaufmann, Philipp Antonio
United States, Royal Oak
William Beaumont Hospital
Lin, Faye Yu Huei
United States, New York
New York Presbyterian Hospital
Chinnaiyan, Kavitha M.
Switzerland, Zurich
Universitatsspital Zurich
Maffei, Erica C.
United States, Bethesda
Walter Reed National Military Medical Center
Raff, Gilbert L.
Switzerland, Zurich
Universitatsspital Zurich
Villines, Todd С.
United States, Bethesda
Walter Reed National Military Medical Center
Gomez, Millie J.
United States, Los Angeles
Cedars-sinai Medical Center
Min, James
United States, Los Angeles
Cedars-sinai Medical Center
Shaw Phd, Leslee J.
United States, Atlanta
Emory University School of Medicine
Statistics
Citations: 31
Authors: 28
Affiliations: 19
Identifiers
Doi:
10.1007/s12350-014-9865-9
ISSN:
10713581
e-ISSN:
15326551
Research Areas
Cancer
Environmental
Study Design
Cross Sectional Study