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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 rates of invasive coronary angiography by category of coronary artery calcium score (CAC).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

OPENHRT2014000233F3: Cumulative rates of invasive coronary angiography by category of coronary artery calcium score (CAC).

Mentions: The higher cumulative rates of invasive coronary angiography by higher categories of CAC score are shown in figure 3. The CAC-score-adjusted HRs (95% CI) for women versus men were 0.98 (0.85 to 1.13) for invasive coronary angiography and 0.73 (0.57 to 0.93) for coronary revascularisation. Further adjustment for age, smoking, diabetes mellitus, treatment for hypertension, and cholesterol-lowering treatment did not change risk estimates (table 3). We found no effect modification by sex on the risk of invasive coronary angiography and coronary revascularisation by increasing CAC score.


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 rates of invasive coronary angiography by category of coronary artery calcium score (CAC).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

OPENHRT2014000233F3: Cumulative rates of invasive coronary angiography by category of coronary artery calcium score (CAC).
Mentions: The higher cumulative rates of invasive coronary angiography by higher categories of CAC score are shown in figure 3. The CAC-score-adjusted HRs (95% CI) for women versus men were 0.98 (0.85 to 1.13) for invasive coronary angiography and 0.73 (0.57 to 0.93) for coronary revascularisation. Further adjustment for age, smoking, diabetes mellitus, treatment for hypertension, and cholesterol-lowering treatment did not change risk estimates (table 3). We found no effect modification by sex on the risk of invasive coronary angiography and coronary revascularisation by increasing CAC score.

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