TY - JOUR
T1 - Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography
T2 - Results from the multicenter CONFIRM registry
AU - Schulman-Marcus, Joshua
AU - Hartaigh, Bríain T.
AU - Giambrone, Ashley E.
AU - Gransar, Heidi
AU - Valenti, Valentina
AU - Berman, Daniel S.
AU - Budoff, Matthew J.
AU - Achenbach, Stephan
AU - Al-Mallah, Mouaz
AU - Andreini, Daniele
AU - Cademartiri, Filippo
AU - Callister, Tracy Q.
AU - Chang, Hyuk Jae
AU - Chinnaiyan, Kavitha
AU - Chow, Benjamin J.W.
AU - Cury, Ricardo
AU - Delago, Augustin
AU - Hadamitzky, Martin
AU - Hausleiter, Joerg
AU - Feuchtner, Gudrun
AU - Kim, Yong Jin
AU - Kaufmann, Philipp A.
AU - Leipsic, Jonathon
AU - Lin, Fay Y.
AU - Maffei, Erica
AU - Pontone, Gianluca
AU - Raff, Gilbert
AU - Shaw, Leslee J.
AU - Villines, Todd C.
AU - Dunning, Allison
AU - Min, James K.
N1 - Funding Information:
Research reported in this publication was supported by the Heart Lung and Blood Institute of the National institutes of Health (Bethesda, Maryland) under award number R01 HL115150. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was supported by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning(MSIP) (2012027176). This study was also funded, in part, by a generous gift from the Dalio Institute of Cardiovascular Imaging (New York, NY) and the Michael Wolk Foundation (New York, NY).
Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objective: This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA). Methods: 1637 patients (mean age 64.8±10.2 years, 69.6% male) with obstructive CAD from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry were followed over the course of three years. Obstructive CAD was defined as a ≥50% stenosis in an epicardial vessel. Medications analyzed included statins, aspirin, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Using Cox proportional-hazards models, we calculated the hazard ratio (HR) with 95% confidence intervals (95% CIs) for incident major adverse cardiovascular events (MACE), defined as death, acute coronary syndrome, or myocardial infarction. Results: At the time of CCTA, 59%, 54%, 40%, and 46% of patients were using statins, aspirin, beta-blockers, and ACE inhibitors or ARBs, respectively. Statins were associated with a 43% (95% CI=0.38-0.87, p=0.008) lower adjusted risk of MACE. Following adjustment, aspirin, beta-blockers, ACE inhibitors and ARBs did not attenuate the risk of MACE. When restricted to patients with multivessel obstructive CAD, only statins were associated with lower risk of MACE. Conclusion: In patients with obstructive CAD by CCTA, the baseline use of statins was associated with improved clinical outcomes. Other cardiac medications-including aspirin, beta-blockers, ACE inhibitors, and ARBs-were not associated with reduced risk of MACE.
AB - Objective: This study sought to determine the correlation between baseline cardiac medications and cardiovascular outcomes in patients with obstructive coronary artery disease (CAD) diagnosed by coronary computed tomographic angiography (CCTA). Methods: 1637 patients (mean age 64.8±10.2 years, 69.6% male) with obstructive CAD from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry were followed over the course of three years. Obstructive CAD was defined as a ≥50% stenosis in an epicardial vessel. Medications analyzed included statins, aspirin, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). Using Cox proportional-hazards models, we calculated the hazard ratio (HR) with 95% confidence intervals (95% CIs) for incident major adverse cardiovascular events (MACE), defined as death, acute coronary syndrome, or myocardial infarction. Results: At the time of CCTA, 59%, 54%, 40%, and 46% of patients were using statins, aspirin, beta-blockers, and ACE inhibitors or ARBs, respectively. Statins were associated with a 43% (95% CI=0.38-0.87, p=0.008) lower adjusted risk of MACE. Following adjustment, aspirin, beta-blockers, ACE inhibitors and ARBs did not attenuate the risk of MACE. When restricted to patients with multivessel obstructive CAD, only statins were associated with lower risk of MACE. Conclusion: In patients with obstructive CAD by CCTA, the baseline use of statins was associated with improved clinical outcomes. Other cardiac medications-including aspirin, beta-blockers, ACE inhibitors, and ARBs-were not associated with reduced risk of MACE.
KW - Coronary artery disease
KW - Coronary computed tomographic angiography
KW - Major adverse cardiac events
KW - Medication therapy
KW - Statins
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U2 - 10.1016/j.atherosclerosis.2014.11.007
DO - 10.1016/j.atherosclerosis.2014.11.007
M3 - Article
C2 - 25479800
AN - SCOPUS:84913557639
VL - 238
SP - 119
EP - 125
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 1
ER -