TY - JOUR
T1 - Sex-Specific Associations between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events the CONFIRM Long-Term Registry
AU - Schulman-Marcus, Joshua
AU - Ó Hartaigh, Bríain
AU - Gransar, Heidi
AU - Lin, Fay
AU - Valenti, Valentina
AU - Cho, Iksung
AU - Berman, Daniel
AU - Callister, Tracy
AU - Delago, Augustin
AU - Hadamitzky, Martin
AU - Hausleiter, Joerg
AU - Al-Mallah, Mouaz
AU - Budoff, Matthew
AU - Kaufmann, Philipp
AU - Achenbach, Stephan
AU - Raff, Gilbert
AU - Chinnaiyan, Kavitha
AU - Cademartiri, Filippo
AU - Maffei, Erica
AU - Villines, Todd
AU - Kim, Yong Jin
AU - Leipsic, Jonathon
AU - Feuchtner, Gudrun
AU - Rubinshtein, Ronen
AU - Pontone, Gianluca
AU - Andreini, Daniele
AU - Marques, Hugo
AU - Shaw, Leslee
AU - Min, James K.
N1 - Publisher Copyright:
© 2016 American College of Cardiology Foundation.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - 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.
AB - 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.
KW - CAD
KW - CT coronary angiography
KW - sex differences
UR - http://www.scopus.com/inward/record.url?scp=84962159071&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2016.02.010
DO - 10.1016/j.jcmg.2016.02.010
M3 - Article
C2 - 27056154
AN - SCOPUS:84962159071
SN - 1936-878X
VL - 9
SP - 364
EP - 372
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 4
ER -