Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry

Otaki Y, Gransar H, Cheng VY, Dey D, Labounty T, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJW, Delago A, Hadamitzky M, Hausleiter J, Kaufmann P, Maffei E, Raff G, Shaw LJ, Villines TC, Dunning A, Cury RC, Feuchtner G, Kim YJ, Leipsic J, Berman DS, Min JK (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Book Volume: 16

Pages Range: 490-9

Journal Issue: 5

DOI: 10.1093/ehjci/jeu281

Abstract

Prior studies examining coronary atherosclerosis in the young have been limited by retrospective analyses in small cohorts. We examined the relationship between cardiovascular risk factors (RFs) and prevalence and severity of coronary atherosclerosis in a large, prospective, multinational registry of consecutive young individuals undergoing coronary computerized tomographic angiography (CCTA).Of 27 125 patients undergoing CCTA, 1635 young (<45 years) individuals without known coronary artery disease (CAD) or coronary anomalies were identified. Coronary plaque was assessed for any CAD, obstructive CAD (>=50% stenosis), and presence of calcified plaque (CP) and non-calcified plaque (NCP). Among 1635 subjects (70% men, age 38 ± 6 years), any CAD, obstructive CAD, CP, and NCP were observed in 19, 4, 5, and 8%, respectively. Compared with women, men demonstrated higher rates of any CAD (21 vs. 12%, P < 0.001), CP (6 vs. 3%, P = 0.01), and NCP (9 vs. 5%, P = 0.008), although no difference was observed for rates of obstructive CAD (5 vs. 4%, P = 0.46). Any CAD, obstructive CAD, and NCP were higher for young individuals with diabetes, hypertension, dyslipidaemia, current smoking, or family history of CAD; while only diabetes and dyslipidaemia were associated with CP. Increasing cardiovascular RFs was associated with a greater prevalence and extent and severity of CAD, with individuals with 0, 1, 2, >=3 RFs manifesting a dose-response increase in any CAD (P < 0.001, for trend), obstructive CAD (P < 0.001, for trend), NCP (P < 0.001, for trend), and CP (P < 0.001, for trend). In multivariable analysis adjusting for sex and cardiovascular RFs, male sex was the strongest predictor for any CAD (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.43-2.66, P < 0.001), CP (OR = 1.46, 95% CI = 1.08-1.98, P = 0.01), and NCP (OR = 1.33, 95% CI = 1.06-1.67, P = 0.01); family history of CAD was the strongest predictor for obstructive CAD (OR = 2.71, 95% CI = 1.65-4.45, P < 0.001).Any and obstructive CAD is present in 1 in 5 and 1 in 20 young individuals, respectively, with family history associated with the greatest risk of obstructive CAD.

Authors with CRIS profile

Involved external institutions

Cornell University United States (USA) (US) Cedars-Sinai Medical Center United States (USA) (US) University of British Columbia Canada (CA) Seoul National University (SNU) / 서울대학교 Korea, Republic of (KR) Medizinische Universität Innsbruck Austria (AT) Baptist Health South Florida United States (USA) (US) New York Presbyterian Hospital United States (USA) (US) Walter Reed Army Medical Center (WRAMC) United States (USA) (US) Emory University United States (USA) (US) Beaumont Health System United States (USA) (US) Casa di Cura Giovanni XXIII Italy (IT) Universitätsspital Zürich (USZ) Switzerland (CH) Deutsches Herzzentrum München Germany (DE) Capitol Cardiology Associates United States (USA) (US) University of Ottawa Canada (CA) Yonsei University Health System (YUHS) Korea, Republic of (KR) Tennessee Heart & Vascular United States (USA) (US) Harbor–UCLA Medical Center United States (USA) (US) Wayne State University (WSU) United States (USA) (US)

How to cite

APA:

Otaki, Y., Gransar, H., Cheng, V.Y., Dey, D., Labounty, T., Lin, F.Y.,... Min, J.K. (2015). Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry. European Heart Journal - Cardiovascular Imaging, 16(5), 490-9. https://doi.org/10.1093/ehjci/jeu281

MLA:

Otaki, Yuka, et al. "Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry." European Heart Journal - Cardiovascular Imaging 16.5 (2015): 490-9.

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