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Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: results from the multicenter CONFIRM registry.


ABSTRACT: 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).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.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.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.

SUBMITTER: Schulman-Marcus J 

PROVIDER: S-EPMC4277901 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Effects of cardiac medications for patients with obstructive coronary artery disease by coronary computed tomographic angiography: results from the multicenter CONFIRM registry.

Schulman-Marcus Joshua J   Hartaigh Bríain Ó BÓ   Giambrone Ashley E AE   Gransar Heidi H   Valenti Valentina V   Berman Daniel S DS   Budoff Matthew J MJ   Achenbach Stephan S   Al-Mallah Mouaz M   Andreini Daniele D   Cademartiri Filippo F   Callister Tracy Q TQ   Chang Hyuk-Jae HJ   Chinnaiyan Kavitha K   Chow Benjamin J W BJ   Cury Ricardo R   Delago Augustin A   Hadamitzky Martin M   Hausleiter Joerg J   Feuchtner Gudrun G   Kim Yong-Jin YJ   Kaufmann Philipp A PA   Leipsic Jonathon J   Lin Fay Y FY   Maffei Erica E   Pontone Gianluca G   Raff Gilbert G   Shaw Leslee J LJ   Villines Todd C TC   Dunning Allison A   Min James K JK  

Atherosclerosis 20141114 1


<h4>Objective</h4>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).<h4>Methods</h4>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 yea  ...[more]

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