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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.
MedLine Citation:
PMID:  25479800     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: 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). Methods: 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. Results: 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. Conclusion: 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.
Authors:
Joshua Schulman-Marcus; Bríain Ó Hartaigh; Ashley E Giambrone; Heidi Gransar; Valentina Valenti; Daniel S Berman; Matthew J Budoff; Stephan Achenbach; Mouaz Al-Mallah; Daniele Andreini; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Kavitha Chinnaiyan; Benjamin J W Chow; Ricardo Cury; Augustin Delago; Martin Hadamitzky; Joerg Hausleiter; Gudrun Feuchtner; Yong-Jin Kim; Philipp A Kaufmann; Jonathon Leipsic; Fay Y Lin; Erica Maffei; Gianluca Pontone; Gilbert Raff; Leslee J Shaw; Todd C Villines; Allison Dunning; James K Min
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-14
Journal Detail:
Title:  Atherosclerosis     Volume:  238     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-6     Completed Date:  -     Revised Date:  2014-12-7    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  119-125     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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