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KMID : 0880420190200071156
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Korean Journal of Radiology
2019 Volume.20 No. 7 p.1156 ~ p.1166
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Subclinical Coronary Atherosclerosis: Implication of Coronary Computed Tomography Angiography Findings among Statin Candidates according to the 2013 ACC/AHA Cholesterol Management Guidelines
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Seo Ji-Woon
Choi Sang-Il
Kim Yeo-Koon
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Abstract
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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.
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KEYWORD
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Coronary artery, Coronary CT angiography, Statin, Atherosclerosis
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