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)

Journal article


Publication Details

Author(s): Lee JH, Han D, Hartaigh BO, 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, Pena JM
Journal: Clinical Cardiology
Publication year: 2018
Volume: 41
Journal issue: 5
Pages range: 586-593
ISSN: 0160-9289


Abstract

Our objective was to assess the prognostic value of symptom typicality in patients without obstructive coronary artery disease (CAD), determined by coronary computed tomographic angiography (CCTA). We identified 4215 patients without prior history of CAD and without obstructive CAD (<50% CCTA stenosis). CAD severity was categorized as nonobstructive (1%-49%) and none (0%). Based upon the Diamond-Forrester criteria for angina pectoris, symptom typicality was classified as asymptomatic, nonanginal, 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. Mean patient age was 57.0 ±12.0 years (54.9% male). During a median follow-up of 5.3 years (interquartile range, 4.6-5.9 years), MACE were reported in 312 (7.4%) patients. Among patients with nonobstructive CAD, there was an association between symptom typicality and MACE (P for interaction = 0.05), driven by increased risk of MACE among those with typical angina and nonobstructive CAD (hazard ratio: 1.62, 95% confidence interval: 1.06-2.48, P = 0.03). No consistent relationship was found between symptom typicality and MACE among patients without any CAD (hazard ratio: 0.73, 95% confidence interval: 0.34-1.57, P = 0.08). In the CONFIRM registry, patients who presented with concomitant typical angina and nonobstructive CAD had a higher rate of MACE than did asymptomatic patients with nonobstructive CAD. However, the presence of typical angina did not appear to portend worse prognosis in patients with no CAD.


FAU Authors / FAU Editors

Achenbach, Stephan Prof. Dr. med.
Lehrstuhl für Innere Medizin II


External institutions with authors

Beaumont Health System
Capitol Cardiology Associates
Cedars-Sinai Medical Center
Deutsches Herzzentrum München
Emory University
Harbor–UCLA Medical Center
Hospital da Luz
King Abdullah International Medical Research Center (KAIMRC)
Leiden University
Ludwig-Maximilians-Universität (LMU)
Medizinische Universität Innsbruck
Myongji Hospital
New York Presbyterian Hospital
SDN Istituto di Ricerca Diagnostica e Nucleare
Seoul National University (SNU) / 서울대학교
Technion - Israel Institute of Technology
Tennessee Heart & Vascular
Università degli studi di Milano
Universitätsklinik Balgrist
University of British Columbia
University of Ottawa
Walter Reed Army Medical Center (WRAMC)


How to cite

APA:
Lee, J.H., Han, D., Hartaigh, B.O., Gransar, H., Lu, Y., Rizvi, A.,... Pena, J.M. (2018). 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). Clinical Cardiology, 41(5), 586-593. https://dx.doi.org/10.1002/clc.22940

MLA:
Lee, Ji Hyun, et al. "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)." Clinical Cardiology 41.5 (2018): 586-593.

BibTeX: 

Last updated on 2019-01-03 at 08:23