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

Joshua Schulman-Marcus, Bríain T. Hartaigh, Ashley E. Giambrone, Heidi Gransar, Valentina Valenti, Daniel S. Berman, Matthew J. Budoff, Stephan Achenbach, Mouaz Al-Mallah, Daniele Andreini, Filippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Kavitha Chinnaiyan, Benjamin J.W. Chow, Ricardo Cury, Augustin Delago, Martin Hadamitzky, Joerg Hausleiter, Gudrun FeuchtnerYong Jin Kim, Philipp A. Kaufmann, Jonathon Leipsic, Fay Y. Lin, Erica Maffei, Gianluca Pontone, Gilbert Raff, Leslee J. Shaw, Todd C. Villines, Allison Dunning, James K. Min

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Abstract

Objective: 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). Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalAtherosclerosis
Volume238
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Schulman-Marcus, J., Hartaigh, B. T., Giambrone, A. E., Gransar, H., Valenti, V., Berman, D. S., Budoff, M. J., Achenbach, S., Al-Mallah, M., Andreini, D., Cademartiri, F., Callister, T. Q., Chang, H. J., Chinnaiyan, K., Chow, B. J. W., Cury, R., Delago, A., Hadamitzky, M., Hausleiter, J., ... 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), 119-125. https://doi.org/10.1016/j.atherosclerosis.2014.11.007