Age- and gender-specific differences in the prognostic value of CT coronary angiography

作者：Yiu Kai Hang; de Graaf Fleur R; Schuijf Joanne D; van Werkhoven Jacob M; Marsan Nina Ajmone; Veltman Caroline E; de Roos Albert; Pazhenkottil Aju; Kroft Lucia J; Boersma Eric; Herzog Bernhard; Leung Melissa; Maffei Erica; Leung Dominic Y; Kaufmann Philipp A; Cademartiri Filippo; Bax Jeroen J; Jukema J Wouter^*

来源：Heart, 2012, 98(3): 232-237.

DOI：10.1136/heartjnl-2011-300038

Objective To evaluate the potential age- and gender-specific differences in the incidence and prognostic value of coronary artery disease (CAD) in patients undergoing CT coronary angiography (CTA). %26lt;br%26gt;Design and patients In this multicentre prospective registry study, 2432 patients (mean age 57 +/- 12, 56% male) underwent CTA for suspected CAD. Patients were stratified into four groups according to age %26lt;60 or %26gt;= 60 years and, male or female gender. %26lt;br%26gt;Main outcome measures A composite end point of cardiac death and non-fatal myocardial infarction. %26lt;br%26gt;Results CTA results were normal in 991 (41%) patients, showed non-significant CAD in 761 (31%) patients and significant CAD in the remaining 680 (28%) patients. During follow-up (median 819 days, 25=75th centile 482=1142) a cardiovascular event occurred in 59 (2.4%) patients. The annualised event rate was 1.1% in the total population (men=1.3% and women=0.9%). In patients aged %26lt;60 years, the annualised event rate of male and female patients was 0.6% and 0.5%, respectively. Among patients aged %26gt;= 60 years the annualised event rate was 1.9% in male and 1.1% in female patients. Observations on CTA predicted events in male patients, both age %26lt;60 and %26gt;= 60 years and in female patients age %26gt;= 60 years (log-rank test in all groups, p%26lt;0.01). However, CTA provided limited prognostic value in female patients aged %26lt;60 years (log-rank test, p=0.45). %26lt;br%26gt;Conclusions After age and gender stratification, CTA findings were shown to be of limited predictive value in female patients aged %26lt;60 years as compared with male patients at any age and female patients aged %26gt;= 60 years.

• 出版日期2012-2