RT Journal Article
SR Electronic
T1 Single-centre cohort study of gender influence in coronary CT angiography in patients with a low to intermediate pretest probability of coronary heart disease
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000233
DO 10.1136/openhrt-2014-000233
VO 2
IS 1
A1 Kirsten Schou Nørgaard
A1 Christin Isaksen
A1 Jørgen Selmer Buhl
A1 Jane Kirk Johansen
A1 Agnete Hedemann Nielsen
A1 Aage Nørgaard
A1 Grazina Urbonaviciene
A1 Jes S Lindholt
A1 Lars Frost
YR 2015
UL http://openheart.bmj.com/content/2/1/e000233.abstract
AB Background In ‘real-world’ patient populations undergoing coronary CT angiography (CCTA), it is unclear whether a correlation exists between gender, coronary artery calcium (CAC) score and subsequent referral for invasive coronary angiography and coronary revascularisation. We therefore investigated the relationship between gender, CAC and use of subsequent invasive coronary angiography and coronary revascularisation in a cohort of patients with chest discomfort and low to intermediate pretest probability of coronary artery disease who underwent a CCTA at our diagnostic centre.Methods This is a cohort study that included patients examined between 2010 and 2013. Data were obtained from the Western Denmark Heart Registry. The follow-up ended 11 March 2014.Results A total of 3541 people (1621 men and 1920 women) were examined by CCTA. The rate of invasive coronary angiography during follow-up was 28.5% in men versus 18.3% in women (p<0.001). The rate of coronary revascularisation during follow-up was 11.4% in men versus 5.1% in women (p<0.001). The CAC-adjusted HR in women versus men was 0.98 (95% CI 0.85 to 1.13) for invasive coronary angiography and 0.73 (95% CI 0.57 to 0.93) for coronary revascularisation. Further adjustment for age and other risk factors did not change these estimates.Conclusions Women had a lower CAC score than men and a corresponding lower rate of invasive coronary angiography. The risk of coronary revascularisation was modestly reduced in women, irrespective of CAC. This may reflect a gender-specific difference in coping with chest discomfort, gender-specific referral bias for CCTA, and/or a gender-specific difference in the balance between coronary calcification and obstructive coronary heart disease.