OBJECTIVE: Symptom presentations suspicious for coronary artery disease (CAD) vary widely. While dyspnea is associated with worse prognosis than typical angina (TypAng) for patients referred for non-invasive CAD imaging, the relation of dyspnea vs. TypAng to adverse measures of CAD prognosis-including severity, burden, composition, and myocardium at risk-has not been examined. METHODS: We studied 1443 consecutive individuals without known CAD (mean 61 ± 13 years, 61.6% men) undergoing coronary computed tomographic angiography (CCTA) who presented with dyspnea (n = 170), TypAng (n = 249) or no dyspnea or TypAng (n = 1024). Multivariable logistic regression was performed to evaluate the association of dyspnea or TypAng to obstructive CAD (≥70% stenosis), plaque burden (total segments with plaque), composition (noncalcified, partially calcified) and location (proximal, mid, or distal location in a coronary artery). RESULTS: By multivariable logistic regression, both dyspnea (OR1.9, 95% CI 1.1-3.3, p = 0.02) and TypAng (OR1.9, 95% CI 1.2-3.1, p = 0.01) were associated with obstructive CAD as compared to individuals without dyspnea or TypAng, while dyspnea (OR1.8, 95% CI 1.1-3.1, p = 0.02), but not TypAng (OR1.1, 95% CI 0.7-1.6, p = 0.76) was associated with plaque in the proximal portions of coronary arteries. Neither symptom type was associated with differences in plaque burden nor composition. CONCLUSION: Both dyspnea and TypAng are associated with higher rates of obstructive CAD compared to those without dyspnea or TypAng, but only dyspnea is associated with coronary plaque in proximal vessel portions.
OBJECTIVE: Symptom presentations suspicious for coronary artery disease (CAD) vary widely. While dyspnea is associated with worse prognosis than typical angina (TypAng) for patients referred for non-invasive CAD imaging, the relation of dyspnea vs. TypAng to adverse measures of CAD prognosis-including severity, burden, composition, and myocardium at risk-has not been examined. METHODS: We studied 1443 consecutive individuals without known CAD (mean 61 ± 13 years, 61.6% men) undergoing coronary computed tomographic angiography (CCTA) who presented with dyspnea (n = 170), TypAng (n = 249) or no dyspnea or TypAng (n = 1024). Multivariable logistic regression was performed to evaluate the association of dyspnea or TypAng to obstructive CAD (≥70% stenosis), plaque burden (total segments with plaque), composition (noncalcified, partially calcified) and location (proximal, mid, or distal location in a coronary artery). RESULTS: By multivariable logistic regression, both dyspnea (OR1.9, 95% CI 1.1-3.3, p = 0.02) and TypAng (OR1.9, 95% CI 1.2-3.1, p = 0.01) were associated with obstructive CAD as compared to individuals without dyspnea or TypAng, while dyspnea (OR1.8, 95% CI 1.1-3.1, p = 0.02), but not TypAng (OR1.1, 95% CI 0.7-1.6, p = 0.76) was associated with plaque in the proximal portions of coronary arteries. Neither symptom type was associated with differences in plaque burden nor composition. CONCLUSION: Both dyspnea and TypAng are associated with higher rates of obstructive CAD compared to those without dyspnea or TypAng, but only dyspnea is associated with coronary plaque in proximal vessel portions.
Authors: Ji Hyun Lee; Donghee Han; Bríain Ó Hartaigh; Heidi Gransar; Yao Lu; Asim Rizvi; Mahn Won Park; Hadi Mirhedayati Roudsari; Wijnand J Stuijfzand; Daniel S Berman; Tracy Q Callister; Augustin DeLago; Martin Hadamitzky; Joerg Hausleiter; Mouaz H Al-Mallah; Matthew J Budoff; Philipp A Kaufmann; Gilbert Raff; Kavitha Chinnaiyan; Filippo Cademartiri; Erica Maffei; Todd C Villines; Yong-Jin Kim; Jonathon Leipsic; Gudrun Feuchtner; Gianluca Pontone; Daniele Andreini; Hugo Marques; Ronen Rubinshtein; Stephan Achenbach; Leslee J Shaw; Hyuk-Jae Chang; Jeroen Bax; Benjamin Chow; Ricardo C Cury; Millie Gomez; Erica C Jones; Fay Y Lin; James K Min; Jessica M Peña Journal: Clin Cardiol Date: 2018-05-11 Impact factor: 2.882
Authors: Angela Lowenstern; Karen P Alexander; Neha J Pagidipati; C Larry Hill; Patricia A Pellikka; Lawton S Cooper; Brooke Alhanti; Udo Hoffmann; Daniel B Mark; Pamela S Douglas Journal: Circ Cardiovasc Qual Outcomes Date: 2022-04-04
Authors: Alexander R van Rosendael; A Maxim Bax; Inge J van den Hoogen; Jeff M Smit; Subhi J Al'Aref; Stephan Achenbach; Mouaz H Al-Mallah; Daniele Andreini; Daniel S Berman; Matthew J Budoff; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Kavitha Chinnaiyan; Benjamin J W Chow; Ricardo C Cury; Augustin DeLago; Gudrun Feuchtner; Martin Hadamitzky; Joerg Hausleiter; Philipp A Kaufmann; Yong-Jin Kim; Jonathon A Leipsic; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Gianluca Pontone; Gilbert L Raff; Ronen Rubinshtein; Todd C Villines; Heidi Gransar; Yao Lu; Jessica M Peña; Fay Y Lin; Leslee J Shaw; Jagat Narula; James K Min; Jeroen J Bax Journal: Eur Heart J Cardiovasc Imaging Date: 2022-01-24 Impact factor: 6.875
Authors: Rajiv Paudel; Natalia Beridze; Wilbert S Aronow; Chul Ahn; Abdallah Sanaani; Pallak Agarwal; Kim Farell; Diwakar Jain; Robert Timmermans; Howard A Cooper; Julio A Panza Journal: Arch Med Sci Date: 2016-07-01 Impact factor: 3.318