Sex-based prognostic implications of nonobstructive coronary artery disease: results from the international multicenter CONFIRM study

Leipsic J, Taylor CM, Gransar H, Shaw LJ, Ahmadi A, Thompson A, Humphries K, Berman DS, Hausleiter J, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chow BJW, Cury RC, Delago AJ, Dunning AL, Feuchtner GM, Hadamitzky M, Kaufmann PA, Lin FY, Chinnaiyan KM, Maffei E, Raff GL, Villines TC, Gomez MJ, Min JK (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Publisher: Radiological Society of North America (RSNA)

Book Volume: 273

Pages Range: 393-400

Journal Issue: 2

DOI: 10.1148/radiol.14140269

Abstract

To determine the clinical outcomes of women and men with nonobstructive coronary artery disease ( CAD coronary artery disease ) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD coronary artery disease risk factors, angina typicality, and CAD coronary artery disease extent and distribution.Institutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD coronary artery disease or nonobstructive (<50% stenosis) CAD coronary artery disease were examined. Men and women were propensity matched for age, CAD coronary artery disease risk factors, angina typicality, and CAD coronary artery disease extent and distribution, which resulted in a final cohort of 11 462 subjects. Nonobstructive CAD coronary artery disease presence and extent were related to incident major adverse cardiovascular events ( MACE major adverse cardiovascular events ), which were inclusive of death and myocardial infarction and were estimated by using multivariable Cox proportional hazards models.At a mean follow-up ± standard deviation of 2.3 years ± 1.1, MACE major adverse cardiovascular events occurred in 164 patients (0.6% annual event rate). After matching, women and men experienced identical annualized rates of myocardial infarction (0.2% vs 0.2%, P = .72), death (0.5% vs 0.5%, P = .98), and MACE major adverse cardiovascular events (0.6% vs 0.6%, P = .94). In multivariable analysis, nonobstructive CAD coronary artery disease was associated with similarly increased MACE major adverse cardiovascular events for both women (hazard ratio: 1.96 [95% confidence interval { CI confidence interval }: 1.17, 3.28], P = .01) and men (hazard ratio: 1.77 [95% CI confidence interval : 1.07, 2.93], P = .03).When matched for age, CAD coronary artery disease risk factors, angina typicality, and nonobstructive CAD coronary artery disease extent, women and men experience comparable rates of incident mortality and myocardial infarction.

Authors with CRIS profile

Involved external institutions

University of British Columbia Canada (CA) Emory University United States (USA) (US) Cedars-Sinai Medical Center United States (USA) (US) Technische Universität München (TUM) Germany (DE) ​King Abdulaziz Medical City Saudi Arabia (SA) Harbor–UCLA Medical Center United States (USA) (US) Casa di Cura Giovanni XXIII Italy (IT) Tennessee Heart & Vascular United States (USA) (US) Yonsei University Health System (YUHS) Korea, Republic of (KR) University of Ottawa Canada (CA) Capitol Cardiology Associates United States (USA) (US) Cornell University United States (USA) (US) Medizinische Universität Innsbruck Austria (AT) Universitätsspital Zürich (USZ) Switzerland (CH) Beaumont Health System United States (USA) (US) Walter Reed Army Medical Center (WRAMC) United States (USA) (US) Baptist Health South Florida United States (USA) (US) Deutsches Herzzentrum München Germany (DE)

How to cite

APA:

Leipsic, J., Taylor, C.M., Gransar, H., Shaw, L.J., Ahmadi, A., Thompson, A.,... Min, J.K. (2014). Sex-based prognostic implications of nonobstructive coronary artery disease: results from the international multicenter CONFIRM study. Radiology, 273(2), 393-400. https://doi.org/10.1148/radiol.14140269

MLA:

Leipsic, Jonathon, et al. "Sex-based prognostic implications of nonobstructive coronary artery disease: results from the international multicenter CONFIRM study." Radiology 273.2 (2014): 393-400.

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