Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: results from the multicenter CONFIRM registry

Schulman-Marcus J, Hartaigh BO, Giambrone AE, Gransar H, Valenti V, Berman DS, Budoff MJ, Achenbach S, Al-Mallah M, Andreini D, Cademartiri F, Callister TQ, Chang HJ, Chinnaiyan K, Chow BJW, Cury R, Delago A, Hadamitzky M, Hausleiter J, Feuchtner G, Kim YJ, Kaufmann PA, Leipsic J, Lin FY, Maffei E, Pontone G, Raff G, Shaw LJ, Villines TC, Dunning A, Min JK (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Book Volume: 238

Pages Range: 119-25

Journal Issue: 1

DOI: 10.1016/j.atherosclerosis.2014.11.007

Abstract

This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA).1637 patients (mean age 64.8 ± 10.2 years, 69.6% male) with obstructive CAD from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry were followed over the course of three years. Obstructive CAD was defined as a >=50% stenosis in an epicardial vessel. Medications analyzed included statins, aspirin, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Using Cox proportional-hazards models, we calculated the hazard ratio (HR) with 95% confidence intervals (95% CIs) for incident major adverse cardiovascular events (MACE), defined as death, acute coronary syndrome, or myocardial infarction.At the time of CCTA, 59%, 54%, 40%, and 46% of patients were using statins, aspirin, beta-blockers, and ACE inhibitors or ARBs, respectively. Statins were associated with a 43% (95% CI = 0.38-0.87, p = 0.008) lower adjusted risk of MACE. Following adjustment, aspirin, beta-blockers, ACE inhibitors and ARBs did not attenuate the risk of MACE. When restricted to patients with multivessel obstructive CAD, only statins were associated with lower risk of MACE.In patients with obstructive CAD by CCTA, the baseline use of statins was associated with improved clinical outcomes. Other cardiac medications-including aspirin, beta-blockers, ACE inhibitors, and ARBs-were not associated with reduced risk of MACE.

Authors with CRIS profile

Involved external institutions

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

How to cite

APA:

Schulman-Marcus, J., Hartaigh, B.O., Giambrone, A.E., Gransar, H., Valenti, V., Berman, D.S.,... Min, J.K. (2015). Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: results from the multicenter CONFIRM registry. Atherosclerosis, 238(1), 119-25. https://doi.org/10.1016/j.atherosclerosis.2014.11.007

MLA:

Schulman-Marcus, Joshua, et al. "Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: results from the multicenter CONFIRM registry." Atherosclerosis 238.1 (2015): 119-25.

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