Literature DB >> 21917657

Age- and gender-specific differences in the prognostic value of CT coronary angiography.

Kai Hang Yiu1, Fleur R de Graaf, Joanne D Schuijf, Jacob M van Werkhoven, Nina Ajmone Marsan, Caroline E Veltman, Albert de Roos, Aju Pazhenkottil, Lucia J Kroft, Eric Boersma, Bernhard Herzog, Melissa Leung, Erica Maffei, Dominic Y Leung, Philipp A Kaufmann, Filippo Cademartiri, Jeroen J Bax, J Wouter Jukema.   

Abstract

OBJECTIVE: To evaluate the potential age- and gender-specific differences in the incidence and prognostic value of coronary artery disease (CAD) in patients undergoing CT coronary angiography (CTA). DESIGN AND PATIENTS: In this multicentre prospective registry study, 2432 patients (mean age 57 ± 12, 56% male) underwent CTA for suspected CAD. Patients were stratified into four groups according to age <60 or ≥60 years and, male or female gender. MAIN OUTCOME MEASURES: A composite end point of cardiac death and non-fatal myocardial infarction.
RESULTS: CTA results were normal in 991 (41%) patients, showed non-significant CAD in 761 (31%) patients and significant CAD in the remaining 680 (28%) patients. During follow-up (median 819 days, 25-75th centile 482-1142) a cardiovascular event occurred in 59 (2.4%) patients. The annualised event rate was 1.1% in the total population (men=1.3% and women=0.9%). In patients aged <60 years, the annualised event rate of male and female patients was 0.6% and 0.5%, respectively. Among patients aged ≥60 years the annualised event rate was 1.9% in male and 1.1% in female patients. Observations on CTA predicted events in male patients, both age <60 and ≥60 years and in female patients age ≥60 years (log-rank test in all groups, p<0.01). However, CTA provided limited prognostic value in female patients aged <60 years (log-rank test, p=0.45).
CONCLUSIONS: After age and gender stratification, CTA findings were shown to be of limited predictive value in female patients aged <60 years as compared with male patients at any age and female patients aged ≥60 years.

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Year:  2011        PMID: 21917657     DOI: 10.1136/heartjnl-2011-300038

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


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