Sex-based prognostic implications of nonobstructive coronary artery disease: Results from the international multicenter CONFIRM study

Jonathon Leipsic, Carolyn M. Taylor, Heidi Gransar, Leslee J. Shaw, Amir Ahmadi, Angus Thompson, Karin Humphries, Daniel S. Berman, Jörg Hausleiter, Stephan Achenbach, Mouaz Al-Mallah, Matthew J. Budoff, Fillippo Cademartiri, Tracy Q. Callister, Hyuk Jae Chang, Benjamin J.W. Chow, Ricardo C. Cury, Augustin J. Delago, Allison L. Dunning, Gudrun M. FeuchtnerMartin Hadamitzky, Philipp A. Kaufmann, Fay Y. Lin, Kavitha M. Chinnaiyan, Erica Maffei, Gilbert L. Raff, Todd C. Villines, Millie J. Gomez, James K. Min

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: To determine the clinical outcomes of women and men with nonobstructive coronary artery disease (CAD) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD risk factors, angina typicality, and CAD extent and distribution.

Materials and Methods: Institutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD or nonobstructive (< 50% stenosis) CAD were examined. Men and women were propensity matched for age, CAD risk factors, angina typicality, and CAD extent and distribution, which resulted in a final cohort of 11 462 subjects. Nonobstructive CAD presence and extent were related to incident major adverse cardiovascular events (MACE), which were inclusive of death and myocardial infarction and were estimated by using multivariable Cox proportional hazards models.

Results: At a mean follow-up±standard deviation of 2.3 years±1.1, MACE occurred in 164 patients (0.6% annual event rate). After matching, women and men experienced identical annualized rates of myocardial infarction (0.2% vs 0.2%, P = .72), death (0.5% vs 0.5%, P = .98), and MACE (0.6% vs 0.6%, P = .94). In multivariable analysis, nonobstructive CAD was associated with similarly increased MACE for both women (hazard ratio: 1.96 [95% confidence interval {CI}: 1.17, 3.28], P = .01) and men (hazard ratio: 1.77 [95% CI: 1.07, 2.93], P = .03).

Conclusion: When matched for age, CAD risk factors, angina typicality, and nonobstructive CAD extent, women and men experience comparable rates of incident mortality and myocardial infarction.

Original languageEnglish
Pages (from-to)393-400
Number of pages8
JournalRadiology
Volume273
Issue number2
DOIs
Publication statusPublished - 2014 Nov 1

Fingerprint

Multicenter Studies
Coronary Artery Disease
Myocardial Infarction
Informed Consent
Angiography
Confidence Intervals
Research Ethics Committees
Proportional Hazards Models
Pathologic Constriction
Cohort Studies
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Leipsic, J., Taylor, C. M., Gransar, H., Shaw, L. J., Ahmadi, A., Thompson, A., ... Min, J. K. (2014). Sex-based prognostic implications of nonobstructive coronary artery disease: Results from the international multicenter CONFIRM study. Radiology, 273(2), 393-400. https://doi.org/10.1148/radiol.14140269
Leipsic, Jonathon ; Taylor, Carolyn M. ; Gransar, Heidi ; Shaw, Leslee J. ; Ahmadi, Amir ; Thompson, Angus ; Humphries, Karin ; Berman, Daniel S. ; Hausleiter, Jörg ; Achenbach, Stephan ; Al-Mallah, Mouaz ; Budoff, Matthew J. ; Cademartiri, Fillippo ; Callister, Tracy Q. ; Chang, Hyuk Jae ; Chow, Benjamin J.W. ; Cury, Ricardo C. ; Delago, Augustin J. ; Dunning, Allison L. ; Feuchtner, Gudrun M. ; Hadamitzky, Martin ; Kaufmann, Philipp A. ; Lin, Fay Y. ; Chinnaiyan, Kavitha M. ; Maffei, Erica ; Raff, Gilbert L. ; Villines, Todd C. ; Gomez, Millie J. ; Min, James K. / Sex-based prognostic implications of nonobstructive coronary artery disease : Results from the international multicenter CONFIRM study. In: Radiology. 2014 ; Vol. 273, No. 2. pp. 393-400.
@article{ddd11a62c63a426b84d5a9b90777f933,
title = "Sex-based prognostic implications of nonobstructive coronary artery disease: Results from the international multicenter CONFIRM study",
abstract = "Purpose: To determine the clinical outcomes of women and men with nonobstructive coronary artery disease (CAD) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD risk factors, angina typicality, and CAD extent and distribution.Materials and Methods: Institutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD or nonobstructive (< 50{\%} stenosis) CAD were examined. Men and women were propensity matched for age, CAD risk factors, angina typicality, and CAD extent and distribution, which resulted in a final cohort of 11 462 subjects. Nonobstructive CAD presence and extent were related to incident major adverse cardiovascular events (MACE), which were inclusive of death and myocardial infarction and were estimated by using multivariable Cox proportional hazards models.Results: At a mean follow-up±standard deviation of 2.3 years±1.1, MACE occurred in 164 patients (0.6{\%} annual event rate). After matching, women and men experienced identical annualized rates of myocardial infarction (0.2{\%} vs 0.2{\%}, P = .72), death (0.5{\%} vs 0.5{\%}, P = .98), and MACE (0.6{\%} vs 0.6{\%}, P = .94). In multivariable analysis, nonobstructive CAD was associated with similarly increased MACE for both women (hazard ratio: 1.96 [95{\%} confidence interval {CI}: 1.17, 3.28], P = .01) and men (hazard ratio: 1.77 [95{\%} CI: 1.07, 2.93], P = .03).Conclusion: When matched for age, CAD risk factors, angina typicality, and nonobstructive CAD extent, women and men experience comparable rates of incident mortality and myocardial infarction.",
author = "Jonathon Leipsic and Taylor, {Carolyn M.} and Heidi Gransar and Shaw, {Leslee J.} and Amir Ahmadi and Angus Thompson and Karin Humphries and Berman, {Daniel S.} and J{\"o}rg Hausleiter and Stephan Achenbach and Mouaz Al-Mallah and Budoff, {Matthew J.} and Fillippo Cademartiri and Callister, {Tracy Q.} and Chang, {Hyuk Jae} and Chow, {Benjamin J.W.} and Cury, {Ricardo C.} and Delago, {Augustin J.} and Dunning, {Allison L.} and Feuchtner, {Gudrun M.} and Martin Hadamitzky and Kaufmann, {Philipp A.} and Lin, {Fay Y.} and Chinnaiyan, {Kavitha M.} and Erica Maffei and Raff, {Gilbert L.} and Villines, {Todd C.} and Gomez, {Millie J.} and Min, {James K.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1148/radiol.14140269",
language = "English",
volume = "273",
pages = "393--400",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

Leipsic, J, Taylor, CM, Gransar, H, Shaw, LJ, Ahmadi, A, Thompson, A, Humphries, K, Berman, DS, Hausleiter, J, Achenbach, S, Al-Mallah, M, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Chow, BJW, Cury, RC, Delago, AJ, Dunning, AL, Feuchtner, GM, Hadamitzky, M, Kaufmann, PA, Lin, FY, Chinnaiyan, KM, Maffei, E, Raff, GL, Villines, TC, Gomez, MJ & Min, JK 2014, 'Sex-based prognostic implications of nonobstructive coronary artery disease: Results from the international multicenter CONFIRM study', Radiology, vol. 273, no. 2, pp. 393-400. https://doi.org/10.1148/radiol.14140269

Sex-based prognostic implications of nonobstructive coronary artery disease : Results from the international multicenter CONFIRM study. / Leipsic, Jonathon; Taylor, Carolyn M.; Gransar, Heidi; Shaw, Leslee J.; Ahmadi, Amir; Thompson, Angus; Humphries, Karin; Berman, Daniel S.; Hausleiter, Jörg; Achenbach, Stephan; Al-Mallah, Mouaz; Budoff, Matthew J.; Cademartiri, Fillippo; Callister, Tracy Q.; Chang, Hyuk Jae; Chow, Benjamin J.W.; Cury, Ricardo C.; Delago, Augustin J.; Dunning, Allison L.; Feuchtner, Gudrun M.; Hadamitzky, Martin; Kaufmann, Philipp A.; Lin, Fay Y.; Chinnaiyan, Kavitha M.; Maffei, Erica; Raff, Gilbert L.; Villines, Todd C.; Gomez, Millie J.; Min, James K.

In: Radiology, Vol. 273, No. 2, 01.11.2014, p. 393-400.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sex-based prognostic implications of nonobstructive coronary artery disease

T2 - Results from the international multicenter CONFIRM study

AU - Leipsic, Jonathon

AU - Taylor, Carolyn M.

AU - Gransar, Heidi

AU - Shaw, Leslee J.

AU - Ahmadi, Amir

AU - Thompson, Angus

AU - Humphries, Karin

AU - Berman, Daniel S.

AU - Hausleiter, Jörg

AU - Achenbach, Stephan

AU - Al-Mallah, Mouaz

AU - Budoff, Matthew J.

AU - Cademartiri, Fillippo

AU - Callister, Tracy Q.

AU - Chang, Hyuk Jae

AU - Chow, Benjamin J.W.

AU - Cury, Ricardo C.

AU - Delago, Augustin J.

AU - Dunning, Allison L.

AU - Feuchtner, Gudrun M.

AU - Hadamitzky, Martin

AU - Kaufmann, Philipp A.

AU - Lin, Fay Y.

AU - Chinnaiyan, Kavitha M.

AU - Maffei, Erica

AU - Raff, Gilbert L.

AU - Villines, Todd C.

AU - Gomez, Millie J.

AU - Min, James K.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Purpose: To determine the clinical outcomes of women and men with nonobstructive coronary artery disease (CAD) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD risk factors, angina typicality, and CAD extent and distribution.Materials and Methods: Institutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD or nonobstructive (< 50% stenosis) CAD were examined. Men and women were propensity matched for age, CAD risk factors, angina typicality, and CAD extent and distribution, which resulted in a final cohort of 11 462 subjects. Nonobstructive CAD presence and extent were related to incident major adverse cardiovascular events (MACE), which were inclusive of death and myocardial infarction and were estimated by using multivariable Cox proportional hazards models.Results: At a mean follow-up±standard deviation of 2.3 years±1.1, MACE occurred in 164 patients (0.6% annual event rate). After matching, women and men experienced identical annualized rates of myocardial infarction (0.2% vs 0.2%, P = .72), death (0.5% vs 0.5%, P = .98), and MACE (0.6% vs 0.6%, P = .94). In multivariable analysis, nonobstructive CAD was associated with similarly increased MACE for both women (hazard ratio: 1.96 [95% confidence interval {CI}: 1.17, 3.28], P = .01) and men (hazard ratio: 1.77 [95% CI: 1.07, 2.93], P = .03).Conclusion: When matched for age, CAD risk factors, angina typicality, and nonobstructive CAD extent, women and men experience comparable rates of incident mortality and myocardial infarction.

AB - Purpose: To determine the clinical outcomes of women and men with nonobstructive coronary artery disease (CAD) with coronary computed tomographic (CT) angiography data in patients who were similar in terms of CAD risk factors, angina typicality, and CAD extent and distribution.Materials and Methods: Institutional review board approval was obtained for all participating sites, with either informed consent or waiver of informed consent. In a prospective international multicenter cohort study of 27 125 patients undergoing coronary CT angiography at 12 centers, 18 158 patients with no CAD or nonobstructive (< 50% stenosis) CAD were examined. Men and women were propensity matched for age, CAD risk factors, angina typicality, and CAD extent and distribution, which resulted in a final cohort of 11 462 subjects. Nonobstructive CAD presence and extent were related to incident major adverse cardiovascular events (MACE), which were inclusive of death and myocardial infarction and were estimated by using multivariable Cox proportional hazards models.Results: At a mean follow-up±standard deviation of 2.3 years±1.1, MACE occurred in 164 patients (0.6% annual event rate). After matching, women and men experienced identical annualized rates of myocardial infarction (0.2% vs 0.2%, P = .72), death (0.5% vs 0.5%, P = .98), and MACE (0.6% vs 0.6%, P = .94). In multivariable analysis, nonobstructive CAD was associated with similarly increased MACE for both women (hazard ratio: 1.96 [95% confidence interval {CI}: 1.17, 3.28], P = .01) and men (hazard ratio: 1.77 [95% CI: 1.07, 2.93], P = .03).Conclusion: When matched for age, CAD risk factors, angina typicality, and nonobstructive CAD extent, women and men experience comparable rates of incident mortality and myocardial infarction.

UR - http://www.scopus.com/inward/record.url?scp=84910094418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84910094418&partnerID=8YFLogxK

U2 - 10.1148/radiol.14140269

DO - 10.1148/radiol.14140269

M3 - Article

C2 - 25028784

AN - SCOPUS:84910094418

VL - 273

SP - 393

EP - 400

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -