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Sex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events: The CONFIRM Long-Term Registry

dc.contributor.authorSchulman-Marcus, J
dc.contributor.authorHartaigh, B
dc.contributor.authorGransar, H
dc.contributor.authorLin, F
dc.contributor.authorValenti, V
dc.contributor.authorCho, I
dc.contributor.authorBerman, D
dc.contributor.authorCallister, T
dc.contributor.authorDeLago, A
dc.contributor.authorHadamitzky, M
dc.contributor.authorHausleiter, J
dc.contributor.authorAl-Mallah, M
dc.contributor.authorBudoff, M
dc.contributor.authorKaufmann, P
dc.contributor.authorAchenbach, S
dc.contributor.authorRaff, G
dc.contributor.authorChinnaiyan, K
dc.contributor.authorCademartiri, F
dc.contributor.authorMaffei, E
dc.contributor.authorVillines, T
dc.contributor.authorKim, Y
dc.contributor.authorLeipsic, J
dc.contributor.authorFeuchtner, G
dc.contributor.authorRubinshtein, R
dc.contributor.authorPontone, G
dc.contributor.authorAndreini, D
dc.contributor.authorMarques, H
dc.contributor.authorShaw, L
dc.contributor.authorMin, J
dc.date.accessioned2017-09-21T11:33:17Z
dc.date.available2017-09-21T11:33:17Z
dc.date.issued2016-04
dc.description.abstractOBJECTIVES: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJACC Cardiovasc Imaging. 2016 Apr;9(4):364-372pt_PT
dc.identifier.doi10.1016/j.jcmg.2016.02.010pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2755
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAgedpt_PT
dc.subjectComputed Tomography Angiographypt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Diseasept_PT
dc.subjectCoronary Stenosispt_PT
dc.subjectDisease Progressionpt_PT
dc.subjectEuropept_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectKaplan-Meier Estimatept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMultidetector Computed Tomographypt_PT
dc.subjectMyocardial Infarctionpt_PT
dc.subjectNorth Americapt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectPrevalencept_PT
dc.subjectPrognosispt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRegistriespt_PT
dc.subjectRepublic of Koreapt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectSex Distributionpt_PT
dc.subjectSex Factorspt_PT
dc.subjectTime Factorspt_PT
dc.subjectCoronary Vesselspt_PT
dc.subjectPlaque, Atheroscleroticpt_PT
dc.subjectHCC CIRpt_PT
dc.titleSex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events: The CONFIRM Long-Term Registrypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage372pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage364pt_PT
oaire.citation.titleJACC: Cardiovascular Imagingpt_PT
oaire.citation.volume9pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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