Author + information
- George A Stouffer,
- Maheswara Satya Gangadhara Rao Golla,
- Timir Paul,
- Siddhartha Rao and
- Chris Wiesen
Coronary artery disease (CAD) starts at an early age and progresses over time. Thus the absence of CAD after a specific age should identity individuals at low risk for development of CAD.
We identified 4068 patients ≥ 40 years of age who had at least two coronary angiograms (CAG) between January 1, 1990 and March 31, 2011. At the time of the first CAG, 227 patients (6%) had no angiographic evidence of CAD (Normal CAG) and 251 patients (6.4%) had ≤30% stenosis by visual analysis (Mild Atherosclerosis).
Patients in the Normal CAG group were younger (54±9 vs 57±10 years; p<0.01), more often female (62% vs 51%; p=0.01) and less likely to use tobacco (41% vs 67%, p<0.01) than patients in Mild Atherosclerosis group. Rates of diabetes, hypertension, LDL levels, BMI and mean time between CAGs (75±46 vs 79±48 months; p=0.4) were the same. Angiographic progression of CAD (OR = 10), development of obstructive CAD (OR = 9), revascularization (OR = 8) and myocardial infarction (OR = 3) were much more frequent in Mild Atherosclerosis group compared to Normal CAG group (Figure). There were no risk factors which identified progression of CAD in Normal CAG group; male gender (OR=2.5, p<0.01) and diabetes (OR=2.1, p<0.01) were risk factors for progression in Mild Atherosclerosis group.
The annual rate of myocardial infarction or revascularization was 1% in patients who had a normal CAG after the age of 40. The presence of mild atherosclerotic disease increased the risk of progression of CAD by 10 fold.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: The Best of Risk Stratification in SIHD
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1110M-70
- 2013 American College of Cardiology Foundation