Limits...
Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease.

Nørgaard KS, Isaksen C, Buhl JS, Kirk Johansen J, Nielsen AH, Nørgaard A, Urbonaviciene G, Lindholt JS, Frost L - Open Heart (2015)

Bottom Line: This is a cohort study that included patients examined between 2010 and 2013.The follow-up ended 11 March 2014.Further adjustment for age and other risk factors did not change these estimates.

View Article: PubMed Central - PubMed

Affiliation: Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital , Silkeborg , Denmark.

ABSTRACT

Background: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre.

Methods: This is a cohort study that included patients examined between 2010 and 2013. Data were obtained from the Western Denmark Heart Registry. The follow-up ended 11 March 2014.

Results: A total of 3541 people (1621 men and 1920 women) were examined by CCTA. The rate of invasive coronary angiography during follow-up was 28.5% in men versus 18.3% in women (p<0.001). The rate of coronary revascularisation during follow-up was 11.4% in men versus 5.1% in women (p<0.001). The CAC-adjusted HR in women versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary revascularisation. Further adjustment for age and other risk factors did not change these estimates.

Conclusions: Women had a lower CAC score than men and a corresponding lower rate of invasive coronary angiography. The risk of coronary revascularisation was modestly reduced in women, irrespective of CAC. This may reflect a gender-specific difference in coping with chest discomfort, gender-specific referral bias for CCTA, and/or a gender-specific difference in the balance between coronary calcification and obstructive coronary heart disease.

No MeSH data available.


Related in: MedlinePlus

Cumulative rate of invasive coronary angiography by sex.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4505361&req=5

OPENHRT2014000233F1: Cumulative rate of invasive coronary angiography by sex.

Mentions: During the study period, 1920 women (median age 61 years) and 1621 men (median age 58 years) underwent a CCTA (tables 1 and 2). Women were older and more often had a family history of ischaemic heart disease. The median CAC score (10th–90th centiles) was 0 (0–351) in women versus 33 (0–701) in men (p<0.001). Total observation time was 5230 years (mean 1.5) for invasive coronary angiography and 6271 years (mean 1.8) for coronary revascularisation. Table 2 and figure 1 show that 18.3% of women and 28.5% of men had an invasive coronary angiography during follow-up (p<0.001). In women, 4.0% had a percutaneous coronary revascularisation versus 8.9% of men (p<0.001), and 1.3% of women and 3.2% of men had coronary artery bypass surgery (p<0.001). The cumulative rate of any coronary revascularisation by sex is shown in figure 2 and was 5.1% in women versus 11.4% in men (p<0.001).


Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease.

Nørgaard KS, Isaksen C, Buhl JS, Kirk Johansen J, Nielsen AH, Nørgaard A, Urbonaviciene G, Lindholt JS, Frost L - Open Heart (2015)

Cumulative rate of invasive coronary angiography by sex.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4505361&req=5

OPENHRT2014000233F1: Cumulative rate of invasive coronary angiography by sex.
Mentions: During the study period, 1920 women (median age 61 years) and 1621 men (median age 58 years) underwent a CCTA (tables 1 and 2). Women were older and more often had a family history of ischaemic heart disease. The median CAC score (10th–90th centiles) was 0 (0–351) in women versus 33 (0–701) in men (p<0.001). Total observation time was 5230 years (mean 1.5) for invasive coronary angiography and 6271 years (mean 1.8) for coronary revascularisation. Table 2 and figure 1 show that 18.3% of women and 28.5% of men had an invasive coronary angiography during follow-up (p<0.001). In women, 4.0% had a percutaneous coronary revascularisation versus 8.9% of men (p<0.001), and 1.3% of women and 3.2% of men had coronary artery bypass surgery (p<0.001). The cumulative rate of any coronary revascularisation by sex is shown in figure 2 and was 5.1% in women versus 11.4% in men (p<0.001).

Bottom Line: This is a cohort study that included patients examined between 2010 and 2013.The follow-up ended 11 March 2014.Further adjustment for age and other risk factors did not change these estimates.

View Article: PubMed Central - PubMed

Affiliation: Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital , Silkeborg , Denmark.

ABSTRACT

Background: In 'real-world' patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre.

Methods: This is a cohort study that included patients examined between 2010 and 2013. Data were obtained from the Western Denmark Heart Registry. The follow-up ended 11 March 2014.

Results: A total of 3541 people (1621 men and 1920 women) were examined by CCTA. The rate of invasive coronary angiography during follow-up was 28.5% in men versus 18.3% in women (p<0.001). The rate of coronary revascularisation during follow-up was 11.4% in men versus 5.1% in women (p<0.001). The CAC-adjusted HR in women versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary revascularisation. Further adjustment for age and other risk factors did not change these estimates.

Conclusions: Women had a lower CAC score than men and a corresponding lower rate of invasive coronary angiography. The risk of coronary revascularisation was modestly reduced in women, irrespective of CAC. This may reflect a gender-specific difference in coping with chest discomfort, gender-specific referral bias for CCTA, and/or a gender-specific difference in the balance between coronary calcification and obstructive coronary heart disease.

No MeSH data available.


Related in: MedlinePlus