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Prevalence and extent of atherosclerotic coronary artery disease and related outcome based on coronary computed tomographic angiography in asymptomatic elderly patients: retrospective cohort study

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Abstract

There is little data regarding coronary artery disease (CAD) and/or atherosclerotic plaques on coronary computed tomographic angiography (CCTA) among the elderly and its outcome, especially in asymptomatic patients. Using CCTA, we evaluated the prevalence and extent of CAD and/or atherosclerosis and related outcomes in asymptomatic elderly patients as compared with symptomatic elderly patients. The study included 1,196 consecutive patients aged 70 years or older who underwent CCTA over a 2-year period. Data were retrospectively evaluated for clinical cardiovascular risk factors with co-morbidities, and CCTA findings, including calcium scores, atherosclerotic plaques (number, plaque-segment score, plaque-extent score, and plaque-significant score) and presence of significant CAD. Follow-up data for active management and all-cause mortality after CCTA were collected for 2 years. Two-sided Student’s t test for independent samples, Chi square contingency tables, and Kaplan–Meier survival curves were used for statistical analysis. Data for 454 asymptomatic and 742 symptomatic elderly patients were analyzed. The prevalence of significant CAD and the extent of atherosclerotic plaques did not differ between the two groups (all P > 0.05). Asymptomatic patients with significant CAD on CCTA, were less likely to receive active management (P < 0.001), which may be related to the higher death rate in this group (P = 0.012) than in the symptomatic patients with significant CAD. Overall, symptoms were not related to the presence of significant CAD or to the extent of atherosclerosis in these elderly patients. However, all-cause mortality was higher in the asymptomatic patients with significant CAD than in the symptomatic ones.

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Acknowledgments

This study was supported by a new faculty research seed money grant of Yonsei University College of Medicine for 8-2012-0074

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea

    Hye-Jeong Lee, Young Jin Kim, Jin Hur, Ji Won Lee, Yoo Jin Hong, Hee Yeong Kim, Tae Hoon Kim & Byoung Wook Choi

  2. Division of Cardiology, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Hyuk-Jae Chang

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  1. Hye-Jeong Lee
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  2. Young Jin Kim
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  3. Jin Hur
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  4. Ji Won Lee
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  5. Yoo Jin Hong
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  6. Hee Yeong Kim
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  7. Hyuk-Jae Chang
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  8. Tae Hoon Kim
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Correspondence to Byoung Wook Choi.

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Lee, HJ., Kim, Y.J., Hur, J. et al. Prevalence and extent of atherosclerotic coronary artery disease and related outcome based on coronary computed tomographic angiography in asymptomatic elderly patients: retrospective cohort study. Int J Cardiovasc Imaging 30, 669–676 (2014). https://doi.org/10.1007/s10554-014-0366-3

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  • DOI: https://doi.org/10.1007/s10554-014-0366-3

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