Subclinical Coronary Atherosclerosis: Implication of Coronary Computed Tomography Angiography Findings among Statin Candidates according to the 2013 ACC/AHA Cholesterol Management Guidelines
- Author:
Jiwoon SEO
1
;
Sang Il CHOI
;
Yeo Koon KIM
Author Information
- Publication Type:Original Article
- Keywords: Coronary artery; Coronary CT angiography; Statin; Atherosclerosis
- MeSH: American Heart Association; Angina, Unstable; Angiography; Atherosclerosis; Cardiology; Cardiovascular Diseases; Cholesterol; Coronary Artery Disease; Coronary Vessels; Death; Disease-Free Survival; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Myocardial Infarction; Retrospective Studies; Risk Assessment
- From:Korean Journal of Radiology 2019;20(7):1156-1166
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To analyze the cardiovascular outcome of statin medication in individuals retrospectively categorized on the basis of the 2013 American College of Cardiology and American Heart Association (ACC/AHA) guidelines risk assessment and to determine the additional prognostic value of coronary computed tomography angiography (CCTA) in assessing cardiovascular disease (CVD) risk in this group. MATERIALS AND METHODS: This retrospective study reviewed 4255 asymptomatic individuals who had undergone self-referred CCTA with a median follow-up period of 87 months. The primary endpoint was major adverse cardiac events (MACEs); these included cardiac death, nonfatal myocardial infarction, and unstable angina. Individuals recommended for statins according to the ACC/AHA guidelines were analyzed by their assessed risk. RESULTS: MACE occurrence was significantly higher in the statin-recommended (SR) group with significant coronary artery disease (CAD) than in those with insignificant CAD (p < 0.001). In individuals with a normal coronary artery on CCTA, MACEs did not occur regardless of statin medication. In the SR group with significant CAD, there was no significant difference between statin users and non-users (p = 0.810). However, in cases with insignificant CAD, the event-free survival was significantly lower among statin users (p = 0.034). In patients recommended for moderate-intensity statins, the segment involvement score on CCTA was significantly associated with a higher risk of MACEs (hazard ratio 2.558; p = 0.001). CONCLUSION: CCTA might have a potential role in CVD risk stratification among asymptomatic statin candidates.
