Coronary dominance and prognosis in patients undergoing coronary computed tomographic angiography: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry

被引：27

作者：

Gebhard, Catherine ^{[1
,2
]}

Fuchs, Tobias A. ^{[1
,2
]}

Stehli, Julia ^{[1
,2
]}

Gransar, Heidi ^{[3
,4
]}

Berman, Daniel S. ^{[3
,4
]}

Budoff, Matthew J. ^{[5
]}

Achenbach, Stephan ^{[6
]}

Al-Mallah, Mouaz ^{[7
]}

Andreini, Daniele ^{[8
]}

Cademartiri, Filippo ^{[9
,10
]}

Callister, Tracy Q. ^{[11
]}

Chang, Hyuk-Jae ^{[12
]}

Chinnaiyan, Kavitha M. ^{[13
]}

Chow, Benjamin J. W. ^{[14
]}

Cury, Ricardo C. ^{[15
]}

Delago, Augustin ^{[16
]}

Gomez, Millie J. ^{[17
,18
]}

Hadamitzky, Martin ^{[19
]}

Hausleiter, Joerg ^{[20
]}

Hindoyan, Niree ^{[17
,18
]}

Feuchtner, Gudrun ^{[21
]}

Kim, Yong-Jin ^{[22
]}

Leipsic, Jonathon ^{[23
,24
]}

Lin, Fay Y. ^{[17
,18
]}

Maffei, Erica ^{[9
]}

Pontone, Gianluca ^{[8
]}

Raff, Gilbert ^{[13
]}

Shaw, Leslee J. ^{[25
,26
]}

Villines, Todd C.

Dunning, Allison M. ^{[27
]}

Min, James K. ^{[17
,18
]}

Kaufmann, Philipp A. ^{[1
,2
]}

机构：

[1] Univ Zurich Hosp, Dept Nucl Med, CH-8091 Zurich, Switzerland

[2] Univ Zurich, Zurich, Switzerland

[3] Cedars Sinai Med Ctr, Cedars Sinai Heart Inst, Dept Imaging, Los Angeles, CA 90048 USA

[4] Cedars Sinai Med Ctr, Cedars Sinai Heart Inst, Dept Med, Los Angeles, CA 90048 USA

[5] Harbor UCLA Med Ctr, Dept Med, Los Angeles, CA USA

[6] Univ Erlangen Nurnberg, Dept Med, Erlangen, Germany

[7] Wayne State Univ, Dept Med, Henry Ford Hosp, Detroit, MI 48202 USA

[8] Univ Milan, IRCCS, Ctr Cardiol Monzino, Dept Clin Sci & Community Hlth, Milan, Italy

[9] Giovanni XXIII Hosp, Cardio Vasc Imaging Unit, Monastier, Italy

[10] Erasmus MC, Dept Radiol, Rotterdam, Netherlands

[11] Tennessee Heart & Vasc Inst, Hendersonville, TN USA

[12] Severance Cardiovasc Hosp, Div Cardiol, Seoul, South Korea

[13] Beaumont Hosp, Royal Oak, MI USA

[14] Univ Ottawa, Inst Heart, Dept Med & Radiol, Ottawa, ON, Canada

[15] Baptist Cardiac & Vasc Inst, Miami, FL USA

[16] Capitol Cardiol Associates, Albany, NY USA

[17] New York Presbyterian Hosp, Dept Radiol, New York, NY USA

[18] Weill Cornell Med Coll, New York, NY USA

[19] Deutsch Herzzentrum Munich, Div Cardiol, Munich, Germany

[20] Univ Munich, Med Klin 1, Munich, Germany

[21] Med Univ Innsbruck, Dept Radiol, A-6020 Innsbruck, Austria

[22] Seoul Natl Univ Hosp, Dept Med & Radiol, Seoul 110744, South Korea

[23] Univ British Columbia, St Pauls Hosp, Dept Med Imaging, Vancouver, BC V5Z 1M9, Canada

[24] Univ British Columbia, St Pauls Hosp, Div Cardiol, Vancouver, BC V5Z 1M9, Canada

[25] Emory Univ, Sch Med, Dept Med, Atlanta, GA USA

[26] Walter Reed Natl Med Ctr, Dept Med, Washington, DC USA

[27] Duke Clin Res Inst, Durham, NC USA

来源：

EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING | 2015年 / 16卷 / 08期

基金：

瑞士国家科学基金会;

关键词：

Coronary dominance; Coronary computed tomographic angiography; Predictive value; ARTERY-DISEASE; DIAGNOSTIC PERFORMANCE; PREVALENCE; METAANALYSIS; MORTALITY; LENGTH; HEART; AGE;

D O I：

10.1093/ehjci/jeu314

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Coronary computed tomographic angiography (CCTA) has become an important tool for non-invasive diagnosis of coronary artery disease (CAD). Coronary dominance can be assessed by CCTA; however, the predictive value of coronary dominance is controversially discussed. The aim of this study was to evaluate the prevalence and prognosis of coronary dominance in a large prospective, international multicentre cohort of patients undergoing CCTA. Methods and results The study population consisted of 6382 patients with or without CAD (47% females, 53% males, mean age 56.9 +/- 12.3 years) who underwent CCTA and were followed over a period of 60 months. Right or left coronary dominance was determined. Right dominance was present in 91% (n = 5817) and left in 9% (n = 565) of the study population. At the end of follow-up, outcome in patients with obstructive CAD (>50% luminal stenosis) and right dominance was similar compared with patients with left dominance [hazard ratio (HR) 0.46, 95% CI 0.16-1.32, P = 0.15]. Furthermore, no differences were observed for the type of coronary dominance in patients with non-obstructive CAD(HR 0.95, 95% CI 0.41-2.21, P = 0.8962) or normal coronary arteries (HR 1.04, 95% CI 0.68-1.59, P = 0.9). Subgroup analysis in patients with left main disease revealed an elevated hazard of the combined endpoint for left dominance (HR 6.45, 95% CI 1.66-25.0, P = 0.007), but not for right dominance. Conclusion In our study population, survival after 5 years of follow-up did not differ significantly between patients with left or right coronary dominance. Thus, assessment of coronary vessel dominance by CCTA may not enhance risk stratification in patients with normal coronary arteries or obstructive CAD, but may add prognostic information for specific subpopulations.

引用

页码：853 / 862

页数：10

共 31 条

[1]

ALLWORK SP, 1987, J ANAT, V153, P1

[2]

Balci Bahattin, 2004, Kardiol Pol, V60, P564

[3] Diagnostic Performance of 64-Multidetector Row Coronary Computed Tomographic Angiography for Evaluation of Coronary Artery Stenosis in Individuals Without Known Coronary Artery Disease [J].