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Usefulness of baseline statin therapy in non-obstructive coronary artery disease by coronary computed tomographic angiography: From the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) study.
Cho, Yun-Kyeong; Nam, Chang-Wook; Koo, Bon-Kwon; Schulman-Marcus, Joshua; Hartaigh, Bríain Ó; Gransar, Heidi; Lu, Yao; Achenbach, Stephan; Al-Mallah, Mouaz; Andreini, Daniele; Bax, Jeroen J; Budoff, Matthew J; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; Cury, Ricardo C; Delago, Augustin; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Jörg; Kaufmann, Philipp A; Kim, Yong-Jin; Leipsic, Jonathon; Maffei, Erica; Marques, Hugo; Pontone, Gianluca; Raff, Gilbert L; Rubinshtein, Ronen; Shaw, Leslee J; Villines, Todd C; Berman, Daniel S; Jones, Erica C; Peña, Jessica M; Lin, Fay Y; Min, James K.
Afiliación
  • Cho YK; Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • Nam CW; Department of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • Koo BK; Department of Internal Medicine and Cardiovascular Center, Seoul National University College of Medicine, Seoul, Korea.
  • Schulman-Marcus J; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Hartaigh BÓ; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Gransar H; Department of Imaging, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
  • Lu Y; Department of Healthcare Policy and Research, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Achenbach S; Department of Cardiology, Friedrich-Alexander-University Erlangen-Nuremburg, Germany.
  • Al-Mallah M; King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King AbdulAziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia.
  • Andreini D; Centro Cardiologico Monzino, IRCCS, Milan, Italy.
  • Bax JJ; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
  • Budoff MJ; Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, California, United States of America.
  • Cademartiri F; Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy.
  • Callister TQ; Tennessee Heart and Vascular Institute, Hendersonville, Tennessee, United States of America.
  • Chang HJ; Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
  • Chinnaiyan K; Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America.
  • Chow BJW; Department of Medicine and Radiology, University of Ottawa, Ontario, Canada.
  • Cury RC; Department of Radiology, Miami Cardiac and Vascular Institute, Miami, Florida, United States of America.
  • Delago A; Capitol Cardiology Associates, Albany, New York, United States of America.
  • Feuchtner G; Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
  • Hadamitzky M; Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany.
  • Hausleiter J; Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany.
  • Kaufmann PA; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
  • Kim YJ; Department of Internal Medicine and Cardiovascular Center, Seoul National University College of Medicine, Seoul, Korea.
  • Leipsic J; Department of Medicine and Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
  • Maffei E; Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy.
  • Marques H; UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal.
  • Pontone G; Centro Cardiologico Monzino, IRCCS, Milan, Italy.
  • Raff GL; Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, United States of America.
  • Rubinshtein R; Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
  • Shaw LJ; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Villines TC; Cardiology Service, Walter Reed National Military Center, Bethesda, Maryland, United States of America.
  • Berman DS; Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America.
  • Jones EC; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Peña JM; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Lin FY; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
  • Min JK; Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York, United States of America.
PLoS One ; 13(12): e0207194, 2018.
Article en En | MEDLINE | ID: mdl-30540755
BACKGROUND: The extent to which the presence and extent of subclinical atherosclerosis by coronary computed tomography angiography influences a potential mortality benefit of statin is unknown. We evaluated the relationship between statin therapy, mortality, and subclinical atherosclerosis. METHODS: In the CONFIRM study, patients with normal or non-obstructive plaque (<50% diameter stenosis) for whom data on baseline statin use was available were included. Coronary artery calcium (CAC) was quantified using the Agatston score. The extent of non-obstructive coronary atherosclerosis was quantified using the segment involvement score (SIS). 8,016 patients were followed for a median of 2.5 years with analysis of all-cause mortality and major adverse cardiac events (MACE) including all-cause mortality, myocardial infarction, unstable angina, target vessel revascularization, and coronary artery disease-related hospitalization. RESULTS: 1.2% of patients experienced all-cause mortality. Patients not on baseline statin therapy had a stepwise increased risk of all-cause mortality by CAC (relative to CAC = 0; CAC 1-99: hazard ratio [HR] 1.65, CAC 100-299: HR 2.19, and CAC≥300: HR 2.98) or SIS (relative to SIS = 0; SIS 1: HR 1.62, SIS 2-3: 2.48 and SIS≥4: 2.95). Conversely, in patients on baseline statin therapy, there was no significant increase in mortality risk with increasing CAC (p value for interaction = 0.049) or SIS (p value for interaction = 0.007). The incidence of MACE was 2.1%. Similar to the all-cause mortality, the risk of MACE was increased with CAC or SIS strata in patient not on baseline statin therapy. However, this relation was not observed in patient on baseline statin therapy. CONCLUSION: In individuals with non-obstructive coronary artery disease, increased risk of adverse events occurs with increasing CAC or SIS who are not on baseline statin therapy. Statin therapy is associated with a mitigation of risk of cardiac events in the presence of increasing atherosclerosis, with no particular threshold of disease burden.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Inhibidores de Hidroximetilglutaril-CoA Reductasas Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos