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Abstract

Aim:

We aimed to examine all-cause mortality risk in relation to the extent of non-obstructive coronary artery disease (CAD) by coronary computed tomography angiography (CTA) in Chinese middle-aged and older patients in a multicenter study with nine-year follow-up.

Methods:

This was a retrospective, observational, multicentre study. The study population consisted of 3,240 consecutive middle-aged and older patients (age ≥ 40 years) with suspected CAD who underwent coronary CTA between June 2011 and December 2013 at three hospitals in Wuhan, China. Patients were grouped according to CAD extent for the final analysis: no CAD, 1-vessel non-obstructive CAD, 2-vessels non-obstructive CAD, and 3-vessels non-obstructive CAD. The primary endpoint was all-cause mortality. Kaplan-Meier method and Cox proportional hazards regression models were used for analysis.

Results:

A total of 2,522 patients were included in the present analysis. Of these, 188 (7.5%) deaths occurred during the median 9.0 years (interquartile range 8.6–9.4) of study follow-up. The annualized all-cause mortality rate was 0.54 (: 0.44–0.68), 0.91 (: 0.68–1.21), 1.44 (: 1.01–1.93), and 2.00 (: 1.46–2.69) for the no CAD, 1-vessel non-obstructive CAD, 2-vessels non-obstructive CAD, and 3-vessels non-obstructive CAD group, respectively. Kaplan–Meier survival curves showed a significant increase in the cumulative events associated with the extent of non-obstructive CAD ( < 0.001). In multivariate Cox regression, after adjustment for age and sex, the presence of 3-vessels non-obstructive CAD was a significant predictor of all-cause mortality ( 1.60, 1.04–2.45, = 0.032).

Conclusion:

In this cohort of Chinese middle-aged and older patients undergoing coronary CTA, the presence and extent of non-obstructive CAD, compared to no CAD, were associated with a significantly greater nine-year risk of all-cause mortality. The present findings suggest the clinical importance of the stage of non-obstructive CAD and warrant investigation of the optimal risk stratification to improve outcomes among these patients.

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2023-09-04
2025-01-10

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Non-obstructive CAD and Risk of All-cause Mortality in Middle-aged and Older Patients: A Nine-year Follow-up and Multicentre Study
20, e220623218148 (2024); https://doi.org/10.2174/1573405620666230622101535
/content/journals/cmim/10.2174/1573405620666230622101535
/content/journals/cmim/10.2174/1573405620666230622101535
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  • Article Type:     Research Article
Keyword(s): Coronary artery disease; Coronary computed tomography angiography; Cox regression; Mortality; Non-obstructive coronary artery disease; Prognosis

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