Sex-based impact of carotid plaque in patients with chest pain undergoing stress echocardiography

Autor: Shahram Ahmadvazir, Rajdeep S. Khattar, Jiwan Pradhan, Roxy Senior
Rok vydání: 2020
Předmět:
Carotid Artery Diseases
Male
medicine.medical_specialty
Myocardial Infarction
Coronary Artery Disease
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Chest pain
Carotid Intima-Media Thickness
Risk Assessment
Angina
Coronary artery disease
03 medical and health sciences
Sex Factors
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Myocardial Revascularization
medicine
Stress Echocardiography
Humans
Angina
Stable
cardiovascular diseases
Myocardial infarction
Adverse effect
Microvascular Angina
business.industry
Middle Aged
medicine.disease
Plaque
Atherosclerotic
United Kingdom
Pre- and post-test probability
Stenosis
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Echocardiography
Stress
Zdroj: Heart. 106:1819-1823
ISSN: 1468-201X
1355-6037
DOI: 10.1136/heartjnl-2019-316507
Popis: ObjectiveWomen with suspected angina without history of coronary artery disease (CAD) less frequently have flow-limiting stenosis (FL-CAD) and more often have microvascular disease, affecting predictive accuracy of stress echocardiography (SE) for detection of FL-CAD. We postulated that carotid plaque burden (CPB) assessment would improve detection of FL-CAD and risk stratification.MethodsConsecutive consenting patients assessed by SE on clinical grounds for new-onset chest pain also underwent simultaneous carotid ultrasound. Patients were followed for major adverse events (MAE): all-cause mortality, non-fatal myocardial infarction and unplanned revascularisation. Carotid plaque presence and burden (CPB) were assessed.ResultsAfter a mean of 2617±469 days (range 17–3740), of 591 recruited patients, 573 (97%) outcome data (314 females) were obtainable. Despite lower pretest probability of CAD in females versus males (14.9±0.8 vs 20.5±1.3, respectively, pConclusionIn females with new-onset stable angina without a history of cardiovascular disease, CPB improved the predictive accuracy of myocardial ischaemia for flow-limiting CAD. However, CPB provided incremental risk stratification in both sexes.
Databáze: OpenAIRE
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