Coronary calcification and male gender predict significant stenosis in symptomatic patients in northern and southern Europe and the USA: A Euro-CCAD study
2016 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645Article in journal (Refereed) Submitted
Background: Significant stenosis is the principal cause of stable angina but its predictors and their variation by geographical region are unclear.
Methods and Results: From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 5515 symptomatic patients from northern Europe (Denmark, France, Germany), southern Europe (Italy, Spain) and USA. All had conventional cardiovascular risk factor assessment, angiography and CT scanning for coronary artery calcium (CAC) scoring. There were considerable differences in the patient characteristics between the groups, with the USA patients being younger and having more diet and lifestyle-related risk factors, although hypertension may have been better controlled than in Europe. USA patients had a two-fold increase in prevalence of significant stenosis and a three-fold increase in median CAC score. In all three groups, the log CAC score proved to be the strongest predictor of >50% stenosis followed by male gender. In the USA group there were no additional independently predictive risk factors, although in northern Europe obesity, hypertension, smoking and hypercholesterolaemia remained predictive, with all risk factors other than age and hypertension proving to be predictive in the southern Europe group. Without the CAC score as a variable, male gender followed by diabetes were the most important predictors in all three regions, with hypertension also proving predictive in northern Europe.
Conclusion: In symptomatic patients, the CAC score and male gender were the most important predictors of significant stenosis in symptomatic patients in northern and southern Europe and the USA.
Place, publisher, year, edition, pages
Oxford: Oxford University Press, 2016.
Stenosis, coronary artery calcification, risk factors, geographical region
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Research subject Cardiology
IdentifiersURN: urn:nbn:se:umu:diva-124924OAI: oai:DiVA.org:umu-124924DiVA: diva2:956607