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[PMID]: | 29521447 | [Au] Autor: | Lee JH; Han D; Hartaigh BÓ; Gransar H; Lu Y; Rizvi A; Park MW; Roudsari HM; Stuijfzand WJ; Berman DS; Callister TQ; DeLago A; Hadamitzky M; Hausleiter J; Al-Mallah MH; Budoff MJ; Kaufmann PA; Raff G; Chinnaiyan K; Cademartiri F; Maffei E; Villines TC; Kim YJ; Leipsic J; Feuchtner G; Pontone G; Andreini D; Marques H; Rubinshtein R; Achenbach S; Shaw LJ; Chang HJ; Bax J; Chow B; Cury RC; Gomez M; Jones EC; Lin FY; Min JK; Peña JM |
[Ad] Address: | Dalio Institute of Cardiovascular Imaging, Department of Radiology, NewYork-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA. | [Ti] Title: | Influence of Symptom Typicality for Predicting MACE in Patients Without Obstructive Coronary Artery Disease: From the CONFIRM Registry (Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry). | [So] Source: | Clin Cardiol;, 2018 Mar 09. | [Is] ISSN: | 1932-8737 | [Cp] Country of publication: | United States | [La] Language: | eng | [Ab] Abstract: | OBJECTIVE: To assess the prognostic value of symptom typicality in patients without obstructive coronary artery disease (CAD), determined by coronary computed tomographic angiography (CCTA). METHODS: 4,215 patients without prior history of CAD and without obstructive CAD (<50% CCTA stenosis) were identified. CAD severity was categorized as non-obstructive (1%-49%) and none (0%). Based upon the Diamond-Forrester criteria for angina pectoris, symptom typicality was classified as: asymptomatic, non-anginal, atypical, and typical. Multivariable Cox proportional hazards models were used to assess the risk of major adverse cardiac events (MACE), comprising all-cause mortality, myocardial infarction, unstable angina and late revascularization, according to symptom typicality. RESULTS: Mean age was 57.0±12.0 years (54.9% male). During a median follow-up of 5.3 years (IQR, 4.6-5.9 years), MACE was reported in 312 (7.4%) patients. Among patients with non-obstructive CAD, there was an association between symptom typicality and MACE (p for interaction =.05), driven by increased risk of MACE among those with typical angina and non-obstructive CAD (HR 1.62, 95% CI: 1.06-2.48, P =.03). No consistent relationship was found between symptom typicality and MACE among patients without any CAD (HR 0.73, 95% CI: 0.34-1.57, P =.08). CONCLUSIONS: In the CONFIRM registry, patients who presented with concomitant typical angina and non-obstructive CAD had a higher rate of MACE than asymptomatic patients with non-obstructive CAD. However, the presence of typical angina did not appear to portend worse prognosis in patients with no CAD. | [Pt] Publication type: | JOURNAL ARTICLE | [Em] Entry month: | 1803 | [Cu] Class update date: |
180309 | [Lr] Last revision date: | 180309 | [St] Status: | Publisher |
[do] DOI: | 10.1002/clc.22940 |
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