Patients with obstructive (≥50% stenosis) left main (LM) coronary artery disease (CAD) are at high risk for adverse events; prior studies have also documented worse outcomes among women than men with severe multivessel/LM CAD. However, the prognostic significance of nonobstructive (1%-49% stenosis) LM CAD, including sex-specific differences, has not been previously examined.
In the long-term CONFIRM (Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter) registry, patients underwent elective coronary computed tomographic angiography for suspected CAD and were followed for 5 years.
According to the data of this Registry, nonobstructive LM CAD was frequently detected on coronary computed tomographic angiography and strongly associated with adverse events among women. Recognizing the sex-specific prognostic significance of nonobstructive LM plaque may augment risk stratification efforts.
- Xie JX, Eshtehardi P, Varghese T, Goyal A, Mehta PK, Kang W, Leipsic J, Ó Hartaigh B, Bairey Merz CN, Berman DS, Gransar H, Budoff MJ, Achenbach S, Callister TQ, Marques H, Rubinshtein R, Al-Mallah MH, Andreini D, Pontone G, Cademartiri F, Maffei E, Chinnaiyan K, Raff G, Hadamitzky M, Hausleiter J, Feuchtner G, Kaufmann PA, Villines TC, Chow BJW, Min JK, Shaw LJ. Prognostic Significance of Nonobstructive Left Main Coronary Artery Disease in Women Versus Men: Long-Term Outcomes From the CONFIRM (Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter) Registry. Circ Cardiovasc Imaging 2017 Aug;10(8). pii: e006246. doi: 10.1161/CIRCIMAGING.117.006246. Go to PubMed