Prognostic Value of Subclinical Coronary Artery Disease in Atrial Fibrillation Patients Identified by Coronary Computed Tomography Angiography

Abstract Introduction Coronary Computed Tomography Angiography (CTA) is an established technique for the detection of coronary artery disease (CAD). However, the prognostic value of non-obstructive CAD is not well defined. Thus, the aim of this analysis is to determine the prognostic value of non-obstructive CAD detected on CTA. Methods In the Multi-Center Multi-Ethnic Coronary Computed Tomography Angiography (MECCA) Study, 3209 subjects without known CAD underwent CTA. Patients with obstructive CAD were excluded from this analysis. Patients with ≤70% luminal coronary artery stenosis in vessels other than the left main were classified to have non-obstructive CAD while patients without any plaque were considered to have normal CTA. Patients were followed up for a median duration of 3.4 years for all-cause mortality (ACM). Multivariable Cox models were used to determine the independent predictors of event-free survival. Results A total of 1455 subjects had non-obstructive CAD and 1382 subjects had normal coronary arteries. Subjects with non-obstructive CAD were older (55.9±11 vs 46.2±11 years, p<0.001) and more likely to be males (56.8% vs 50.5%, p=0.001) and had more prevalent traditional risk factors. A total of 83 ACM were observed (4.4% in the non-obstructive group and 1.3% in the normal group, p<0.001). Patients with clinical events were older (61.8±14 vs 50.9±12 years, p<0.001) and have more prevalence of DM (42.2% vs 31.4%, p=0.031) and HTN (72.3% vs 54.3%, p=0.001). In Multivariable Cox models, non-obstructive CAD was associated with increased event rate (Hazard ratio 1.75, 95% CI 1.01–3.01, p=0.45). Kaplan-Meier Survival Curves Conclusions Patients with non-obstructive CAD on CTA have a higher rate of all-cause mortality. Non-obstructive CAD on CTA enhances risk stratification among subjects suspected with CAD and should call for more aggressive guidelines directed medical therapy. Acknowledgement/Funding None

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Use of Coronary Computed Tomography Angiography to Screen Hospital Employees with Cardiovascular Risk Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105462 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5462

Author(s):

Po-Yi Li ◽

Ru-Yih Chen ◽

Fu-Zong Wu ◽

Guang-Yuan Mar ◽

Ming-Ting Wu ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Computed Tomography Angiography ◽

Coronary Computed Tomography Angiography ◽

Significant Risk ◽

Coronary Computed Tomography ◽

Hospital Employees ◽

Artery Disease

The objective of this study was to determine how coronary computed tomography angiography (CCTA) can be employed to detect coronary artery disease in hospital employees, enabling early treatment and minimizing damage. All employees of our hospital were assessed using the Framingham Risk Score. Those with a 10-year risk of myocardial infarction or death of >10% were offered CCTA; the Coronary Artery Disease Reporting and Data System (CAD-RADS) score was the outcome. A total of 3923 hospital employees were included, and the number who had received CCTA was 309. Among these 309, 31 (10.0%) had a CAD-RADS score of 3–5, with 10 of the 31 (32.3%) requiring further cardiac catheterization; 161 (52.1%) had a score of 1–2; and 117 (37.9%) had a score of 0. In the multivariate logistic regression, only age of ≥ 55 years (p < 0.05), hypertension (p < 0.05), and hyperlipidemia (p < 0.05) were discovered to be significant risk factors for a CAD-RADS score of 3–5. Thus, regular and adequate control of chronic diseases is critical for patients, and more studies are required to be confirmed if there are more significant risk factors.

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