Subclinical Coronary Atherosclerosis: Implication of Coronary Computed Tomography Angiography Findings among Statin Candidates according to the 2013 ACC/AHA Cholesterol Management Guidelines
Korean Journal of Radiology
;
: 1156-1166, 2019.
Article
in English
| WPRIM
| ID: wpr-760285
ABSTRACT
OBJECTIVE:
To analyze the cardiovascular outcome of statin medication in individuals retrospectively categorized on the basis of the 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines risk assessment and to determine the additional prognostic value of coronary computed tomography angiography (CCTA) in assessing cardiovascular disease (CVD) risk in this group. MATERIALS ANDMETHODS:
This retrospective study reviewed 4255 asymptomatic individuals who had undergone self-referred CCTA with a median follow-up period of 87 months. The primary endpoint was major adverse cardiac events (MACEs); these included cardiac death, nonfatal myocardial infarction, and unstable angina. Individuals recommended for statins according to the ACC/AHA guidelines were analyzed by their assessed risk.RESULTS:
MACE occurrence was significantly higher in the statin-recommended (SR) group with significant coronary artery disease (CAD) than in those with insignificant CAD (p < 0.001). In individuals with a normal coronary artery on CCTA, MACEs did not occur regardless of statin medication. In the SR group with significant CAD, there was no significant difference between statin users and non-users (p = 0.810). However, in cases with insignificant CAD, the event-free survival was significantly lower among statin users (p = 0.034). In patients recommended for moderate-intensity statins, the segment involvement score on CCTA was significantly associated with a higher risk of MACEs (hazard ratio 2.558; p = 0.001).CONCLUSION:
CCTA might have a potential role in CVD risk stratification among asymptomatic statin candidates.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Coronary Artery Disease
/
Angiography
/
Cardiology
/
Cardiovascular Diseases
/
Cholesterol
/
Retrospective Studies
/
Follow-Up Studies
/
Risk Assessment
/
Disease-Free Survival
/
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Type of study:
Diagnostic study
/
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Korean Journal of Radiology
Year:
2019
Type:
Article
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