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105. The burden of non‐cardiac comorbidities and association with clinical outcomes in an acute heart failure trial – insights from ASCEND‐HF

Author

Bhatt, Ankeet S., primary, Ambrosy, Andrew P., additional, Dunning, Allison, additional, DeVore, Adam D., additional, Butler, Javed, additional, Reed, Shelby, additional, Voors, Adriaan, additional, Starling, Randall, additional, Armstrong, Paul W., additional, Ezekowitz, Justin A., additional, Metra, Marco, additional, Hernandez, Adrian F., additional, O'Connor, Christopher M., additional, and Mentz, Robert J., additional

Published
2020
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108. Superior risk stratification with coronary CTA using a comprehensive atherosclerotic risk score

Author

van Rosendael, Alexander R., Shaw, Leslee J., Xie, Joe X., Dimitriu-Leen, Aukelien C., Smit, Jeff M., Scholte, Arthur J., van Werkhoven, Jacob M., Callister, Tracey Q., DeLago, Augustin, Berman, Daniel S., Hadamitzky, Martin, Hausleiter, Jeorg, Al-Mallah, Mouaz H., Budoff, Matthew J., Kaufmann, Philipp A., Raff, Gilbert, Chinnaiyan, Kavitha, Cademartiri, Filippo, Maffei, Erica, Villines, Todd C., Yong-Jin, Kim, Feuchtner, Gudrun, Lin, Fay Y., Jones, Erica C., Pontone, Gianluca, Andreini, Daniele, Marques, Hugo, Rubinshtein, Ronen, Achenbach, Stephan, Dunning, Allison, Gomez, Millie, Hindoyan, Niree, Gransar, Heidi, Leipsic, Jonathon, Narula, Jagat, Min, James K., and Bax, Jeroen J.

Subjects
Computed Tomography Angiography, Humans, Heart, cardiovascular diseases, Coronary Angiography, Tomography, X-Ray Computed, Risk Assessment, Article
Abstract

OBJECTIVES: To assess the prognostic value of a new, comprehensive coronary computed tomography angiography (CTA) score compared with the stenosis severity component of the Coronary Artery Disease – Reporting and Data System (CAD-RAD S). BACKGROUND: Current risk assessment with coronary CTA is mainly focused on maximal stenosis severity. Integration of plaque extent, location and composition in a comprehensive model may improve risk stratification. METHODS: A total of 2,134 patients with suspected but without known CAD were included. The predictive value of the comprehensive CTA score (ranging from 0–42 and divided into three groups: 0–5, 6–20, and >20) was compared with the CAD-RADS combined into 3 groups (0 – 30%, 30 – 70% and ≥70% stenosis). Its predictive performance was internally and externally validated (using the 5-year follow-up dataset of the Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry (CONFIRM) registry, n = 1,971). RESULTS: Patients mean age was 55±13 years, mean follow-up 3.6 ± 2.8 years and 130 events (myocardial infarction or death) occurred. The new, comprehensive CTA score demonstrated strong and independent predictive value using Cox proportional hazard analysis. A model including clinical variables + comprehensive CTA score showed better discrimination of events compared with a model consisting of clinical variables + CAD-RADS (0.768 vs 0.742, P=0.001). Also, the comprehensive CTA score correctly reclassified a significant proportion of patients compared with conventional approach (net reclassification improvement 12.4%, P

Published
2019

110. The relationship of hypertension to coronary atherosclerosis and cardiac events in patients with coronary CT angiography

Author

Nakanishi, Rine, Baskaran, Lohendran, Gransar, Heidi, Budoff, Matthew J., Achenbach, Stephan, Al-Mallah, Mouaz, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin J. W., DeLago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Cury, Ricardo, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Kaufmann, Philipp A., Maffei, Erica, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, Marques, Hugo, Pontone, Gianluca, Andreini, Daniele, Rubinshtein, Ronen, Bax, Jeroen, Jones, Erica, Hindoyan, Niree, Gomez, Millie, Lin, Fay Y., Min, James K., and Berman, Daniel S.

Subjects
Male, Computed Tomography Angiography, International Cooperation, Myocardial Ischemia, Coronary Artery Disease, Middle Aged, Coronary Angiography, Prognosis, Risk Assessment, Severity of Illness Index, Article, Outcome and Process Assessment, Health Care, Risk Factors, Hypertension, Humans, Female, Prospective Studies, Registries, Aged, Proportional Hazards Models
Abstract

Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5,5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events.

Published
2017

111. Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure: From the ASCEND-HF Trial

Author

Greene, Stephen J., Hernandez, Adrian F., Dunning, Allison, Ambrosy, Andrew P., Armstrong, Paul W., Butler, Javed, Cerbin, Lukasz P., Coles, Adrian, Ezekowitz, Justin A., Metra, Marco, Starling, Randall C., Teerlink, John R., Voors, Adriaan A., O'Connor, Christopher M., Mentz, Robert J., and Cardiovascular Centre (CVC)

Subjects
Male, de novo, Time Factors, IMPACT, acute heart failure, chronic, Aged, Disease Progression, Dose-Response Relationship, Drug, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Hospitalization, Humans, Injections, Intravenous, Middle Aged, Natriuretic Agents, Natriuretic Peptide, Brain, Odds Ratio, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Survival Rate, Endpoint Determination, Cardiology and Cardiovascular Medicine, NESIRITIDE, Injections, Dose-Response Relationship, Natriuretic Peptide, PREDICTORS, OUTCOMES, MORTALITY, Brain, PREVALENCE, EVEREST TRIAL, Drug, Intravenous, REDUCED EJECTION FRACTION
Abstract

BACKGROUND It is unclear how patients hospitalized for acute heart failure (HF) who are long-term chronic HF survivors differ from those with more recent HF diagnoses. OBJECTIVES The goal of this study was to evaluate the influence of HF chronicity on acute HF patient profiles and outcomes. METHODS The ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial randomized 7,141 hospitalized patients with acute HF with reduced or preserved ejection fraction (EF) to receive nesiritide or placebo in addition to standard care. The present analysis compared patients according to duration of HF diagnosis before index hospitalization by using pre-specified cutoffs (0 to 1 month [i.e., "recently diagnosed"], >1 to 12 months, >12 to 60 months, and >60 months). RESULTS Overall, 5,741 (80.4%) patients had documentation of duration of HF diagnosis (recently diagnosed, n = 1,536; >1 to 12 months, n = 1,020; >12 to 60 months, n = 1,653; and >60 months, n = 1,532). Across HF duration groups, mean age ranged from 64 to 66 years, and mean ejection fraction ranged from 29% to 32%. Compared with patients with longer HF duration, recently diagnosed patients were more likely to be women with nonischemic HF etiology, higher baseline blood pressure, better baseline renal function, and fewer comorbidities. After adjustment, compared with recently diagnosed patients, patients with longer HF duration were associated with more persistent dyspnea at 24 h (>1 to 12 months, odds ratio [OR]: 1.20; 95% confidence interval [CI]: 0.97 to 1.48; >12 to 60 months, OR: 1.34; 95% CI: 1.11 to 1.62; and >60 months, OR: 1.31; 95% CI: 1.08 to 1.60) and increased 180-day mortality (>1 to 12 months, hazard ratio [HR]: 1.89; 95% CI: 1.35 to 2.65; >12 to 60 months, HR: 1.82; 95% CI: 1.33 to 2.48; and >60 months, HR: 2.02; 95% CI: 1.47 to 2.77). The influence of HF duration on mortality was potentially more pronounced among female patients (interaction p = 0.05), but did not differ according to age, race, prior ischemic heart disease, or ejection fraction (all interactions, p >= 0.23). CONCLUSIONS In this acute HF trial, patient profile differed according to duration of the HF diagnosis. A diagnosis of HF for

Published
2017

114. Current but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiography

Author

Nakanishi, Rine, Berman, Daniel S., Budoff, Matthew J., Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Cheng, Victor Y., Chinnaiyan, Kavitha, Chow, Benjamin J.W., Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Jörg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A., Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, Min, James K., Nakanishi, Rine, Berman, Daniel S., Budoff, Matthew J., Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Cheng, Victor Y., Chinnaiyan, Kavitha, Chow, Benjamin J.W., Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Jörg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A., Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, and Min, James K.

Abstract

Aims We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD): 10.6% vs. 14.9% vs. 15.2%, P < 0.001; 2-VD: 4.4% vs. 6.1% vs. 6.2%, P = 0.001; 3-VD: 3.1% vs. 5.2% vs. 4.3%, P < 0.001]. Compared with never smokers, current smokers experienced higher MACE risk [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.4-2.6, P < 0.001], while past smokers did not (HR 1.2, 95% CI 0.8-1.6, P = 0.35). Among matched individuals, current smokers had higher MACE risk (HR 2.6, 95% CI 1.6-4.2, P < 0.001), while past smokers did not (HR 1.3, 95% CI 0.7-2.4, P = 0.39). Similar findings were observed for risk of all-cause death. Conclusion Among patients without known CAD undergoing CCTA, current and past smokers had increased burden of atherosclerosis compared with never smokers; however, risk of MACE was heightened only in current smokers

Published
2017

115. Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry

Author

Otaki, Yuka, Gransar, Heidi, Cheng, Victor Y., Dey, Damini, Labounty, Troy, Lin, Fay Y., Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J., Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin J.W., Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, Cury, Ricardo C., Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S., Min, James K., Otaki, Yuka, Gransar, Heidi, Cheng, Victor Y., Dey, Damini, Labounty, Troy, Lin, Fay Y., Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J., Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin J.W., Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison, Cury, Ricardo C., Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S., and Min, James K.

Abstract

Objective Prior studies examining coronary atherosclerosis in the young have been limited by retrospective analyses in small cohorts. We examined the relationship between cardiovascular risk factors (RFs) and prevalence and severity of coronary atherosclerosis in a large, prospective, multinational registry of consecutive young individuals undergoing coronary computerized tomographic angiography (CCTA). Method and results Of 27 125 patients undergoing CCTA, 1635 young (<45 years) individuals without known coronary artery disease (CAD) or coronary anomalies were identified. Coronary plaque was assessed for any CAD, obstructive CAD (≥50% stenosis), and presence of calcified plaque (CP) and non-calcified plaque (NCP). Among 1635 subjects (70% men, age 38 ± 6 years), any CAD, obstructive CAD, CP, and NCP were observed in 19, 4, 5, and 8%, respectively. Compared with women, men demonstrated higher rates of any CAD (21 vs. 12%, P < 0.001), CP (6 vs. 3%, P = 0.01), and NCP (9 vs. 5%, P = 0.008), although no difference was observed for rates of obstructive CAD (5 vs. 4%, P = 0.46). Any CAD, obstructive CAD, and NCP were higher for young individuals with diabetes, hypertension, dyslipidaemia, current smoking, or family history of CAD; while only diabetes and dyslipidaemia were associated with CP. Increasing cardiovascular RFs was associated with a greater prevalence and extent and severity of CAD, with individuals with 0, 1, 2, ≥3 RFs manifesting a dose-response increase in any CAD (P < 0.001, for trend), obstructive CAD (P < 0.001, for trend), NCP (P < 0.001, for trend), and CP (P < 0.001, for trend). In multivariable analysis adjusting for sex and cardiovascular RFs, male sex was the strongest predictor for any CAD (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.43-2.66, P < 0.001), CP (OR = 1.46, 95% CI = 1.08-1.98, P = 0.01), and NCP (OR = 1.33, 95% CI = 1.06-1.67, P = 0.01); family history of CAD was the strongest predictor for obstructive CAD (OR = 2.71, 95%

Published
2017

116. 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

Author

Gebhard, Catherine, Fuchs, Tobias A., Stehli, Julia, Gransar, Heidi, Berman, Daniel S., Budoff, Matthew J., Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha M., Chow, Benjamin J. W., Cury, Ricardo C., Delago, Augustin, Gomez, Millie J., Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison M., Min, James K., Kaufmann, Philipp A., Gebhard, Catherine, Fuchs, Tobias A., Stehli, Julia, Gransar, Heidi, Berman, Daniel S., Budoff, Matthew J., Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha M., Chow, Benjamin J. W., Cury, Ricardo C., Delago, Augustin, Gomez, Millie J., Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y., Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J., Villines, Todd C., Dunning, Allison M., Min, James K., and Kaufmann, Philipp A.

Abstract

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

Published
2017

118. Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry

Author

Villines Todd C, Hulten Edward A, Shaw Leslee J, Goyal Manju, Dunning Allison, Achenbach Stephan, Al-Mallah Mouaz, Berman Daniel S, Budoff Matthew J, Cademartiri Filippo, Callister Tracy Q, Chang Hyuk-Jae, Cheng Victor Y, Chinnaiyan Kavitha, Chow Benjamin J W, Delago Augustin, Hadamitzky Martin, Hausleiter Jörg, Kaufmann Philipp, Lin Fay Y, Maffei Erica, Raff Gilbert L, Min James K, and CONFIRM Registry Investigators

Subjects
nutritional and metabolic diseases, cardiovascular diseases
Abstract

OBJECTIVES The purpose of this study was to describe the prevalence and severity of coronary artery disease (CAD) in relation to prognosis in symptomatic patients without coronary artery calcification (CAC) undergoing coronary computed tomography angiography (CCTA). BACKGROUND The frequency and clinical relevance of CAD in patients without CAC are unclear. METHODS We identified 10037 symptomatic patients without CAD who underwent concomitant CCTA and CAC scoring. CAD was assessed as 0 had a sensitivity specificity and negative and positive predictive values for stenosis =50 of 89 59 96 and 29 respectively. During a median of 2.1 years there was no difference in mortality among patients with a CAC score of 0 irrespective of obstructive CAD. Among 8907 patients with follow up for the composite endpoint 3.9 with a CAC score of 0 and =50 stenosis experienced an event (hazard ratio: 5.7; 95 confidence interval: 2.5 to 13.1; p < 0.001) compared with 0.8 of patients with a CAC score of 0 and no obstructive CAD. Receiver operator characteristic curve analysis demonstrated that the CAC score did not add incremental prognostic information compared with CAD extent on CCTA for the composite endpoint (CCTA area under the curve = 0.825; CAC + CCTA area under the curve = 0.826; p = 0.84). CONCLUSIONS In symptomatic patients with a CAC score of 0 obstructive CAD is possible and is associated with increased cardiovascular events. CAC scoring did not add incremental prognostic information to CCTA.

Published
2011
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119. Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: insights from ASCEND-HF

Author

Fudim, Marat, primary, O'Connor, Christopher M., additional, Dunning, Allison, additional, Ambrosy, Andrew P., additional, Armstrong, Paul W., additional, Coles, Adrian, additional, Ezekowitz, Justin A., additional, Greene, Stephen J., additional, Metra, Marco, additional, Starling, Randall C., additional, Voors, Adriaan A., additional, Hernandez, Adrian F., additional, Michael Felker, G., additional, and Mentz, Robert J., additional

Published
2017
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120. Causes of Death in a Contemporary Cohort of Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: Insights From the TECOS Trial

Author

Sharma, Abhinav, primary, Green, Jennifer B., additional, Dunning, Allison, additional, Lokhnygina, Yuliya, additional, Al-Khatib, Sana M., additional, Lopes, Renato D., additional, Buse, John B., additional, Lachin, John M., additional, Van de Werf, Frans, additional, Armstrong, Paul W., additional, Kaufman, Keith D., additional, Standl, Eberhard, additional, Chan, Juliana C.N., additional, Distiller, Larry A., additional, Scott, Russell, additional, Peterson, Eric D., additional, and Holman, Rury R., additional

Published
2017
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121. The Burden of Non-Cardiac Comorbidities in Acute Heart Failure: Insights From ASCEND-HF

Author

Bhatt, Ankeet S., primary, Ambrosy, Andrew P., additional, Dunning, Allison, additional, Coles, Adrian, additional, DeVore, Adam D., additional, Butler, Javed, additional, Hernandez, Adrian F., additional, Armstrong, Paul, additional, Ezekowitz, Justin, additional, Voors, Adriaan, additional, Starling, Randall, additional, Metra, Marco, additional, O'Connor, Christopher, additional, and Mentz, Robert J., additional

Published
2017
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122. Incremental prognostic value of coronary computed tomography angiography over coronary calcium scoring for major adverse cardiac events in elderly asymptomatic individuals

Author

Han, Donghee, primary, Hartaigh, Bríain Ó, additional, Gransar, Heidi, additional, Lee, Ji Hyun, additional, Rizvi, Asim, additional, Baskaran, Lohendran, additional, Schulman-Marcus, Joshua, additional, Dunning, Allison, additional, Achenbach, Stephan, additional, Al-Mallah, Mouaz H, additional, Berman, Daniel S, additional, Budoff, Matthew J, additional, Cademartiri, Filippo, additional, Maffei, Erica, additional, Callister, Tracy Q, additional, Chinnaiyan, Kavitha, additional, Chow, Benjamin J W, additional, DeLago, Augustin, additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Kaufmann, Philipp A, additional, Raff, Gilbert, additional, Shaw, Leslee J, additional, Villines, Todd C, additional, Kim, Yong-Jin, additional, Leipsic, Jonathon, additional, Feuchtner, Gudrun, additional, Cury, Ricardo C, additional, Pontone, Gianluca, additional, Andreini, Daniele, additional, Marques, Hugo, additional, Rubinshtein, Ronen, additional, Hindoyan, Niree, additional, Jones, Erica C, additional, Gomez, Millie, additional, Lin, Fay Y, additional, Chang, Hyuk-Jae, additional, and Min, James K, additional

Published
2017
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123. Prognostic implications of coronary artery calcium in the absence of coronary artery luminal narrowing

Author

Cho, Iksung, primary, ó Hartaigh, Bríain, additional, Gransar, Heidi, additional, Valenti, Valentina, additional, Lin, Fay Y., additional, Achenbach, Stephan, additional, Berman, Daniel S., additional, Budoff, Matthew J., additional, Callister, Tracy Q., additional, Al-Mallah, Mouaz H., additional, Cademartiri, Filippo, additional, Chinnaiyan, Kavitha, additional, Chow, Benjamin J.W., additional, Dunning, Allison M., additional, DeLago, Augustin, additional, Villines, Todd C., additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Leipsic, Jonathon, additional, Shaw, Leslee J., additional, Kaufmann, Philipp A., additional, Cury, Ricardo C., additional, Feuchtner, Gudrun, additional, Kim, Yong-Jin, additional, Maffei, Erica, additional, Raff, Gilbert, additional, Pontone, Gianluca, additional, Andreini, Daniele, additional, Chang, Hyuk-Jae, additional, and Min, James K., additional

Published
2017
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124. Coronary revascularization vs. medical therapy following coronary-computed tomographic angiography in patients with low-, intermediate- and high-risk coronary artery disease: results from the CONFIRM long-term registry

Author

Schulman-Marcus, Joshua, primary, Lin, Fay Y., additional, Gransar, Heidi, additional, Berman, Daniel, additional, Callister, Tracy, additional, DeLago, Augustin, additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Al-Mallah, Mouaz, additional, Budoff, Matthew, additional, Kaufmann, Philipp, additional, Achenbach, Stephan, additional, Raff, Gilbert, additional, Chinnaiyan, Kavitha, additional, Cademartiri, Filippo, additional, Maffei, Erica, additional, Villines, Todd, additional, Kim, Yong-Jin, additional, Leipsic, Jonathon, additional, Feuchtner, Gudrun, additional, Rubinshtein, Ronen, additional, Pontone, Gianluca, additional, Andreini, Daniele, additional, Marques, Hugo, additional, Chang, Hyuk-Jae, additional, Chow, Benjamin J.W., additional, Cury, Ricardo C., additional, Dunning, Allison, additional, Shaw, Leslee, additional, and Min, James K., additional

Published
2017
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125. TIMING AND CLINICAL PREDICTORS OF EARLY VERSUS LATE READMISSION AMONG PATIENTS HOSPITALIZED FOR ACUTE HEART FAILURE: INSIGHTS FROM ASCEND-HF

Author

Fudim, Marat, primary, Ambrosy, Andrew, additional, Dunning, Allison, additional, Starling, Randall, additional, Ezekowitz, Justin, additional, Armstrong, Paul, additional, Metra, Marco, additional, Voors, Adriaan, additional, O'Connor, Christopher, additional, Hernandez, Adrian, additional, Felker, G. Michael, additional, and Mentz, Robert, additional

Published
2017
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126. Predictive Value of Age- and Sex-Specific Nomograms of Global Plaque Burden on Coronary Computed Tomography Angiography for Major Cardiac Events

Author

Naoum, Christopher, primary, Berman, Daniel S., additional, Ahmadi, Amir, additional, Blanke, Philipp, additional, Gransar, Heidi, additional, Narula, Jagat, additional, Shaw, Leslee J., additional, Kritharides, Leonard, additional, Achenbach, Stephan, additional, Al-Mallah, Mouaz H., additional, Andreini, Daniele, additional, Budoff, Matthew J., additional, Cademartiri, Filippo, additional, Callister, Tracy Q., additional, Chang, Hyuk-Jae, additional, Chinnaiyan, Kavitha, additional, Chow, Benjamin, additional, Cury, Ricardo C., additional, DeLago, Augustin, additional, Dunning, Allison, additional, Feuchtner, Gudrun, additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Kaufmann, Philipp A., additional, Kim, Yong-Jin, additional, Maffei, Erica, additional, Marquez, Hugo, additional, Pontone, Gianluca, additional, Raff, Gilbert, additional, Rubinshtein, Ronen, additional, Villines, Todd C., additional, Min, James, additional, and Leipsic, Jonathon, additional

Published
2017
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127. Mechanically Adaptive Materials for Intracortical Implants

Author

Jorfi, Mehdi, Potter, Kelsey A., Nguyen, Jessica K., Hess-Dunning, Allison E., Johan Foster, Capadona, Jeffrey R., Weder, Christoph, and IEEE

Abstract

Cortical microelectrodes allow electrical contacts with neural cells and show promise as electrical interfaces to the brain, which allow for the treatment of several neurological deficits. However, the functionality of current electrodes decreases over time, in part due to neuron degeneration and foreign body encapsulation. One hypothesis is that the mismatch of the mechanical properties of the electrode and the brain tissue is a significant contributor to these events. We recently developed a new approach to chemically responsive, mechanically adaptive polymer nanocomposites, which are initially highly rigid, but soften considerably upon exposure to physiological conditions and aqueous environments in general. Initial in-vivo experiments suggest that the materials promise to be a useful platform for the design of next-generation intracortical devices.

Published
2015

128. Medical history for prognostic risk assessment and diagnosis of stable patients with suspected coronary artery disease

Author

Min, James K, Dunning, Allison, Gransar, Heidi, Achenbach, Stephan, Lin, Fay Y, Al-Mallah, Mouaz, Budoff, Matthew J, Callister, Tracy Q, Chang, Hyuk-Jae, Cademartiri, Filippo, Maffei, Erica, Chinnaiyan, Kavitha, Chow, Benjamin J W, D'Agostino, Ralph, DeLago, Augustin, Friedman, John, Hadamitzky, Martin, Hausleiter, Joerg, Hayes, Sean W, Kaufmann, Philipp, Raff, Gilbert L, Shaw, Leslee J, Thomson, Louise, Villines, Todd, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S, Pencina, Michael, University of Zurich, and Min, James K

Subjects
610 Medicine & health, 10181 Clinic for Nuclear Medicine, 2700 General Medicine
Published
2015
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129. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry) registry

Author

Chow, Benjamin JW, Small, Gary, Yam, Yeung, Chen, Li, McPherson, Ruth, Achenbach, Stephan, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gundrun, Hadamitzky, Martin, Hausleiter, Jörg, Karlsberg, Ronald P, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, LaBounty, Troy, Lin, Fay, Maffei, Erica, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, Min, James K, and CONFIRM Investigators

Subjects
Male, Time Factors, Coronary Artery Disease, Kaplan-Meier Estimate, Cardiorespiratory Medicine and Haematology, Coronary Angiography, Cardiovascular, Severity of Illness Index, Risk Factors, Odds Ratio, Registries, Prospective Studies, Tomography, screening and diagnosis, Middle Aged, X-Ray Computed, Primary Prevention, Europe, Detection, Treatment Outcome, Heart Disease, 6.1 Pharmaceuticals, Female, Patient Safety, 4.2 Evaluation of markers and technologies, Adult, Canada, Asia, aspirin, Clinical Sciences, CONFIRM Investigators, Predictive Value of Tests, Clinical Research, Humans, Heart Disease - Coronary Heart Disease, Proportional Hazards Models, Aged, Coronary Stenosis, statin, Evaluation of treatments and therapeutic interventions, coronary atherosclerosis, Protective Factors, Atherosclerosis, mortality, United States, Good Health and Well Being, Cardiovascular System & Hematology, Multivariate Analysis, prognosis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Platelet Aggregation Inhibitors
Abstract

ObjectiveWe sought to examine the risk of mortality associated with nonobstructive coronary artery disease (CAD) and to determine the impact of baseline statin and aspirin use on mortality.Approach and resultsCoronary computed tomographic angiography permits direct visualization of nonobstructive CAD. To date, the prognostic implications of nonobstructive CAD and the potential benefit of directing therapy based on nonobstructive CAD have not been carefully examined. A total of 27 125 consecutive patients who underwent computed tomographic angiography (12 enrolling centers and 6 countries) were prospectively entered into the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry. Patients, without history of previous CAD or obstructive CAD, for whom baseline statin and aspirin use was available were analyzed. Each coronary segment was classified as normal or nonobstructive CAD (1%-49% stenosis). Patients were followed up for a median of 27.2 months for all-cause mortality. The study comprised 10 418 patients (5712 normal and 4706 with nonobstructive CAD). In multivariable analyses, patients with nonobstructive CAD had a 6% (95% confidence interval, 1%-12%) higher risk of mortality for each additional segment with nonobstructive plaque (P=0.021). Baseline statin use was associated with a reduced risk of mortality (hazard ratio, 0.44; 95% confidence interval, 0.28-0.68; P=0.0003), a benefit that was present for individuals with nonobstructive CAD (hazard ratio, 0.32; 95% confidence interval, 0.19-0.55; P

Published
2015

130. Genetically Predicted Body Mass Index and Breast Cancer Risk: Mendelian Randomization Analyses of Data from 145,000 Women of European Descent.

Author

Guo, Yan, Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose IA, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, Verhoef, Senno, Guo, Yan, Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose IA, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, and Verhoef, Senno

Abstract

BackgroundObservational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or environmental factors.MethodsWe applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated genetically predicted BMI in association with breast cancer risk using individual-level data from the Breast Cancer Association Consortium (BCAC) (cases = 46,325, controls = 42,482). We further evaluated the association between genetically predicted BMI and breast cancer risk using summary statistics from 16,003 cases and 41,335 controls from the Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) Project. Because most studies measured BMI after cancer diagnosis, we could not conduct a parallel analysis to adequately evaluate the association of measured BMI with breast cancer risk prospectively.ResultsIn the BCAC data, genetically predicted BMI was found to be inversely associated with breast cancer risk (odds ratio [OR] = 0.65 per 5 kg/m2 increase, 95% confidence interval [CI]: 0.56-0.75, p = 3.32 × 10-10). The associations were similar for both premenopausal (OR = 0.44, 95% CI:0.31-0.62, p = 9.91 × 10-8) and postmenopausal breast cancer (OR = 0.57, 95% CI: 0.46-0.71, p = 1.88 × 10-8). This association was replicated in the data from the DRIVE consortium (OR = 0.72, 95% CI: 0.60-0.84, p = 1.64 × 10-7). Single marker analyses identified 17 of the 84 BMI-associated single nucleotide polymorphisms (SNPs) in association with breast cancer risk at p < 0.05; for 16 of them, the allele associated with elevated BMI was associated with red

Published
2016

131. Genetically Predicted Body Mass Index and Breast Cancer Risk: Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

Author

Genetica Sectie Genoomdiagnostiek, Cancer, Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose I A, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, Verhoef, Senno, Whittemore, Alice S, Winqvist, Robert, Zhao, Hui, Zhao, Shilin, Hall, Per, Simard, Jacques, Kraft, Peter, Pharoah, Paul, Hunter, David, Easton, Douglas F, Zheng, Wei, Genetica Sectie Genoomdiagnostiek, Cancer, Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose I A, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, Verhoef, Senno, Whittemore, Alice S, Winqvist, Robert, Zhao, Hui, Zhao, Shilin, Hall, Per, Simard, Jacques, Kraft, Peter, Pharoah, Paul, Hunter, David, Easton, Douglas F, and Zheng, Wei

Published
2016

132. Genetically Predicted Body Mass Index and Breast Cancer Risk:Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

Author

Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose I A, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, Verhoef, Senno, Whittemore, Alice S, Winqvist, Robert, Zhao, Hui, Zhao, Shilin, Hall, Per, Simard, Jacques, Kraft, Peter, Pharoah, Paul, Hunter, David, Easton, Douglas F, Zheng, Wei, Guo, Yan, Warren Andersen, Shaneda, Shu, Xiao-Ou, Michailidou, Kyriaki, Bolla, Manjeet K, Wang, Qin, Garcia-Closas, Montserrat, Milne, Roger L, Schmidt, Marjanka K, Chang-Claude, Jenny, Dunning, Allison, Bojesen, Stig E, Ahsan, Habibul, Aittomäki, Kristiina, Andrulis, Irene L, Anton-Culver, Hoda, Arndt, Volker, Beckmann, Matthias W, Beeghly-Fadiel, Alicia, Benitez, Javier, Bogdanova, Natalia V, Bonanni, Bernardo, Børresen-Dale, Anne-Lise, Brand, Judith, Brauch, Hiltrud, Brenner, Hermann, Brüning, Thomas, Burwinkel, Barbara, Casey, Graham, Chenevix-Trench, Georgia, Couch, Fergus J, Cox, Angela, Cross, Simon S, Czene, Kamila, Devilee, Peter, Dörk, Thilo, Dumont, Martine, Fasching, Peter A, Figueroa, Jonine, Flesch-Janys, Dieter, Fletcher, Olivia, Flyger, Henrik, Fostira, Florentia, Gammon, Marilie, Giles, Graham G, Guénel, Pascal, Haiman, Christopher A, Hamann, Ute, Hooning, Maartje J, Hopper, John L, Jakubowska, Anna, Jasmine, Farzana, Jenkins, Mark, John, Esther M, Johnson, Nichola, Jones, Michael E, Kabisch, Maria, Kibriya, Muhammad, Knight, Julia A, Koppert, Linetta B, Kosma, Veli-Matti, Kristensen, Vessela, Le Marchand, Loic, Lee, Eunjung, Li, Jingmei, Lindblom, Annika, Luben, Robert, Lubinski, Jan, Malone, Kathi E, Mannermaa, Arto, Margolin, Sara, Marme, Frederik, McLean, Catriona, Meijers-Heijboer, Hanne, Meindl, Alfons, Neuhausen, Susan L, Nevanlinna, Heli, Neven, Patrick, Olson, Janet E, Perez, Jose I A, Perkins, Barbara, Peterlongo, Paolo, Phillips, Kelly-Anne, Pylkäs, Katri, Rudolph, Anja, Santella, Regina, Sawyer, Elinor J, Schmutzler, Rita K, Seynaeve, Caroline, Shah, Mitul, Shrubsole, Martha J, Southey, Melissa C, Swerdlow, Anthony J, Toland, Amanda E, Tomlinson, Ian, Torres, Diana, Truong, Thérèse, Ursin, Giske, Van Der Luijt, Rob B, Verhoef, Senno, Whittemore, Alice S, Winqvist, Robert, Zhao, Hui, Zhao, Shilin, Hall, Per, Simard, Jacques, Kraft, Peter, Pharoah, Paul, Hunter, David, Easton, Douglas F, and Zheng, Wei

Abstract

BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or environmental factors.METHODS: We applied Mendelian randomization to evaluate the association between BMI and risk of breast cancer occurrence using data from two large breast cancer consortia. We created a weighted BMI genetic score comprising 84 BMI-associated genetic variants to predicted BMI. We evaluated genetically predicted BMI in association with breast cancer risk using individual-level data from the Breast Cancer Association Consortium (BCAC) (cases = 46,325, controls = 42,482). We further evaluated the association between genetically predicted BMI and breast cancer risk using summary statistics from 16,003 cases and 41,335 controls from the Discovery, Biology, and Risk of Inherited Variants in Breast Cancer (DRIVE) Project. Because most studies measured BMI after cancer diagnosis, we could not conduct a parallel analysis to adequately evaluate the association of measured BMI with breast cancer risk prospectively.RESULTS: In the BCAC data, genetically predicted BMI was found to be inversely associated with breast cancer risk (odds ratio [OR] = 0.65 per 5 kg/m2 increase, 95% confidence interval [CI]: 0.56-0.75, p = 3.32 × 10-10). The associations were similar for both premenopausal (OR = 0.44, 95% CI:0.31-0.62, p = 9.91 × 10-8) and postmenopausal breast cancer (OR = 0.57, 95% CI: 0.46-0.71, p = 1.88 × 10-8). This association was replicated in the data from the DRIVE consortium (OR = 0.72, 95% CI: 0.60-0.84, p = 1.64 × 10-7). Single marker analyses identified 17 of the 84 BMI-associated single nucleotide polymorphisms (SNPs) in association with breast cancer risk at p < 0.05; for 16 of them, the allele associated with elevated BMI

Published
2016

133. Abstract 13158: Hospitalization for De Novo versus Worsening Chronic Heart Failure: Insights From the ASCEND-HF Trial

Author

Greene, Stephen J, primary, Hernandez, Adrian F, additional, Dunning, Allison, additional, Ambrosy, Andrew P, additional, Armstrong, Paul W, additional, Butler, Javed, additional, Cerbin, Lukasz, additional, Coles, Adrian, additional, Ezekowitz, Justin A, additional, Metra, Marco, additional, Starling, Randall C, additional, Teerlink, John R, additional, Voors, Adriaan A, additional, O’Connor, Christopher M, additional, and Mentz, Robert J, additional

Published
2016
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134. Improved 5-year prediction of all-cause mortality by coronary CT angiography applying the CONFIRM score

Author

Deseive, Simon, primary, Shaw, Leslee J., additional, Min, James K., additional, Achenbach, Stephan, additional, Andreini, Daniele, additional, Al-Mallah, Mouaz H., additional, Berman, Daniel S., additional, Budoff, Matthew J., additional, Callister, Tracy Q., additional, Cademartiri, Filippo, additional, Chang, Hyuk-Jae, additional, Chinnaiyan, Kavitha, additional, Chow, Benjamin J.W., additional, Cury, Ricardo C., additional, DeLago, Augustin, additional, Dunning, Allison M., additional, Feuchtner, Gudrun, additional, Kaufmann, Philipp A., additional, Kim, Yong-Jin, additional, Leipsic, Jonathon, additional, Marques, Hugo, additional, Maffei, Erica, additional, Pontone, Gianluca, additional, Raff, Gilbert, additional, Rubinshtein, Ronin, additional, Villines, Todd C., additional, Hausleiter, Jörg, additional, and Hadamitzky, Martin, additional

Published
2016
Full Text
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135. Genetically Predicted Body Mass Index and Breast Cancer Risk: Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

Author

Guo, Yan, primary, Warren Andersen, Shaneda, additional, Shu, Xiao-Ou, additional, Michailidou, Kyriaki, additional, Bolla, Manjeet K., additional, Wang, Qin, additional, Garcia-Closas, Montserrat, additional, Milne, Roger L., additional, Schmidt, Marjanka K., additional, Chang-Claude, Jenny, additional, Dunning, Allison, additional, Bojesen, Stig E., additional, Ahsan, Habibul, additional, Aittomäki, Kristiina, additional, Andrulis, Irene L., additional, Anton-Culver, Hoda, additional, Arndt, Volker, additional, Beckmann, Matthias W., additional, Beeghly-Fadiel, Alicia, additional, Benitez, Javier, additional, Bogdanova, Natalia V., additional, Bonanni, Bernardo, additional, Børresen-Dale, Anne-Lise, additional, Brand, Judith, additional, Brauch, Hiltrud, additional, Brenner, Hermann, additional, Brüning, Thomas, additional, Burwinkel, Barbara, additional, Casey, Graham, additional, Chenevix-Trench, Georgia, additional, Couch, Fergus J., additional, Cox, Angela, additional, Cross, Simon S., additional, Czene, Kamila, additional, Devilee, Peter, additional, Dörk, Thilo, additional, Dumont, Martine, additional, Fasching, Peter A., additional, Figueroa, Jonine, additional, Flesch-Janys, Dieter, additional, Fletcher, Olivia, additional, Flyger, Henrik, additional, Fostira, Florentia, additional, Gammon, Marilie, additional, Giles, Graham G., additional, Guénel, Pascal, additional, Haiman, Christopher A., additional, Hamann, Ute, additional, Hooning, Maartje J., additional, Hopper, John L., additional, Jakubowska, Anna, additional, Jasmine, Farzana, additional, Jenkins, Mark, additional, John, Esther M., additional, Johnson, Nichola, additional, Jones, Michael E., additional, Kabisch, Maria, additional, Kibriya, Muhammad, additional, Knight, Julia A., additional, Koppert, Linetta B., additional, Kosma, Veli-Matti, additional, Kristensen, Vessela, additional, Le Marchand, Loic, additional, Lee, Eunjung, additional, Li, Jingmei, additional, Lindblom, Annika, additional, Luben, Robert, additional, Lubinski, Jan, additional, Malone, Kathi E., additional, Mannermaa, Arto, additional, Margolin, Sara, additional, Marme, Frederik, additional, McLean, Catriona, additional, Meijers-Heijboer, Hanne, additional, Meindl, Alfons, additional, Neuhausen, Susan L., additional, Nevanlinna, Heli, additional, Neven, Patrick, additional, Olson, Janet E., additional, Perez, Jose I. A., additional, Perkins, Barbara, additional, Peterlongo, Paolo, additional, Phillips, Kelly-Anne, additional, Pylkäs, Katri, additional, Rudolph, Anja, additional, Santella, Regina, additional, Sawyer, Elinor J., additional, Schmutzler, Rita K., additional, Seynaeve, Caroline, additional, Shah, Mitul, additional, Shrubsole, Martha J., additional, Southey, Melissa C., additional, Swerdlow, Anthony J., additional, Toland, Amanda E., additional, Tomlinson, Ian, additional, Torres, Diana, additional, Truong, Thérèse, additional, Ursin, Giske, additional, Van Der Luijt, Rob B., additional, Verhoef, Senno, additional, Whittemore, Alice S., additional, Winqvist, Robert, additional, Zhao, Hui, additional, Zhao, Shilin, additional, Hall, Per, additional, Simard, Jacques, additional, Kraft, Peter, additional, Pharoah, Paul, additional, Hunter, David, additional, Easton, Douglas F., additional, and Zheng, Wei, additional

Published
2016
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136. Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study

Author

Gebhard, Catherine, primary, Buechel, Ronny R., additional, Stähli, Barbara E., additional, Gransar, Heidi, additional, Achenbach, Stephan, additional, Berman, Daniel S., additional, Budoff, Matthew J., additional, Callister, Tracy Q., additional, Chow, Benjamin, additional, Dunning, Allison, additional, Al-Mallah, Mouaz H., additional, Cademartiri, Filippo, additional, Chinnaiyan, Kavitha, additional, Rubinshtein, Ronen, additional, Marques, Hugo, additional, DeLago, Augustin, additional, Villines, Todd C., additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Shaw, Leslee J., additional, Cury, Ricardo C., additional, Feuchtner, Gudrun, additional, Kim, Yong-Jin, additional, Maffei, Erica, additional, Raff, Gilbert, additional, Pontone, Gianluca, additional, Andreini, Daniele, additional, Chang, Hyuk-Jae, additional, Leipsic, Jonathon, additional, Min, James K., additional, and Kaufmann, Philipp A., additional

Published
2016
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137. Machine learning for prediction of all-cause mortality in patients with suspected coronary artery disease: a 5-year multicentre prospective registry analysis

Author

Motwani, Manish, primary, Dey, Damini, additional, Berman, Daniel S., additional, Germano, Guido, additional, Achenbach, Stephan, additional, Al-Mallah, Mouaz H., additional, Andreini, Daniele, additional, Budoff, Matthew J., additional, Cademartiri, Filippo, additional, Callister, Tracy Q., additional, Chang, Hyuk-Jae, additional, Chinnaiyan, Kavitha, additional, Chow, Benjamin J.W., additional, Cury, Ricardo C., additional, Delago, Augustin, additional, Gomez, Millie, additional, Gransar, Heidi, additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Hindoyan, Niree, additional, Feuchtner, Gudrun, additional, Kaufmann, Philipp A., additional, Kim, Yong-Jin, additional, Leipsic, Jonathon, additional, Lin, Fay Y., additional, Maffei, Erica, additional, Marques, Hugo, additional, Pontone, Gianluca, additional, Raff, Gilbert, additional, Rubinshtein, Ronen, additional, Shaw, Leslee J., additional, Stehli, Julia, additional, Villines, Todd C., additional, Dunning, Allison, additional, Min, James K., additional, and Slomka, Piotr J., additional

Published
2016
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139. PROGNOSTIC VALUE OF RIGHT-SIDED VOLUME OVERLOAD IN PATIENTS PRESENTING WITH ACUTE HEART FAILURE: INSIGHTS FROM ASCEND-HF

Author

Parikh, Kishan S., primary, DeVore, Adam, additional, Dunning, Allison, additional, Mentz, Robert, additional, Schulte, Phillip, additional, Armstrong, Paul, additional, Tang, Wai Hong, additional, Ezekowitz, Justin, additional, McMurray, John, additional, Voors, Adriaan, additional, Drazner, Mark, additional, O’Connor, Christopher, additional, Hernandez, Adrian, additional, and Patel, Chetan, additional

Published
2016
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140. NONOBSTRUCTIVE LEFT MAIN CORONARY ARTERY DISEASE ON CORONARY CT ANGIOGRAPHY AND RISK FOR MYOCARDIAL INFARCTION

Author

Xie, Joe, primary, Goyal, Abhinav, additional, Leipsic, Jonathon, additional, Hartaigh, Briain O., additional, Berman, Daniel, additional, Budoff, Matthew, additional, Achenbach, Stephan, additional, Dunning, Allison, additional, Callister, Tracy, additional, DeLago, Augustin, additional, Marques, Hugo, additional, Rubinshtein, Ronen, additional, Al-Mallah, Mouaz H., additional, Andreini, Daniele, additional, Cademartiri, Filippo, additional, Chinnaiyan, Kavitha, additional, Hadamitzky, Martin, additional, Feuchtner, Gudrun, additional, Kim, Yong-Jin, additional, Kaufmann, Philipp, additional, Pontone, Gianluca, additional, Raff, Gilbert, additional, Villines, Todd, additional, Min, James, additional, and Shaw, Leslee, additional

Published
2016
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141. LONG-TERM MORTALITY BENEFIT OF EARLY CORONARY REVASCULARIZATION VERSUS MEDICAL THERAPY IN PATIENTS WITHOUT KNOWN CORONARY ARTERY DISEASE UNDERGOING CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY: RESULTS FROM CONFIRM REGISTRY

Author

Schulman-Marcus, Joshua, primary, Lin, Fay, additional, Gransar, Heidi, additional, Berman, Daniel, additional, Callister, Tracy, additional, DeLago, Augustin, additional, Hadamitzky, Martin, additional, Hausleiter, Joerg, additional, Al-Mallah, Mouaz, additional, Budoff, Matthew, additional, Kaufmann, Philipp, additional, Achenbach, Stephan, additional, Raff, Gilbert, additional, Chinnaiyan, Kavitha, additional, Cademartiri, Filippo, additional, Maffei, Erica, additional, Villines, Todd, additional, Kim, Yong-Jin, additional, Leipsic, Jonathon, additional, Rubinshtein, Ronen, additional, Feuchtner, Gudrun, additional, Pontone, Gianluca, additional, Dunning, Allison, additional, Shaw, Leslee, additional, and Min, James, additional

Published
2016
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142. Clinical Implications of Cluster Analysis-Based Classification of Acute Decompensated Heart Failure and Correlation with Bedside Hemodynamic Profiles

Author

Ahmad, Tariq, primary, Desai, Nihar, additional, Wilson, Francis, additional, Schulte, Phillip, additional, Dunning, Allison, additional, Jacoby, Daniel, additional, Allen, Larry, additional, Fiuzat, Mona, additional, Rogers, Joseph, additional, Felker, G. Michael, additional, O’Connor, Christopher, additional, and Patel, Chetan B., additional

Published
2016
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143. Aortic valve surgery and survival in patients with moderate or severe aortic stenosis and left ventricular dysfunction

Author

Samad, Zainab, primary, Vora, Amit N., additional, Dunning, Allison, additional, Schulte, Phillip J., additional, Shaw, Linda K., additional, Al-Enezi, Fawaz, additional, Ersboll, Mads, additional, McGarrah, Robert W., additional, Vavalle, John P., additional, Shah, Svati H., additional, Kisslo, Joseph, additional, Glower, Donald, additional, Harrison, J. Kevin, additional, and Velazquez, Eric J., additional

Published
2016
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144. 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.

Author

Gebhard, Catherine, Gebhard, Catherine, Fuchs, Tobias A, Stehli, Julia, Gransar, Heidi, Berman, Daniel S, Budoff, Matthew J, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha M, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin, Gomez, Millie J, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison M, Min, James K, Kaufmann, Philipp A, Gebhard, Catherine, Gebhard, Catherine, Fuchs, Tobias A, Stehli, Julia, Gransar, Heidi, Berman, Daniel S, Budoff, Matthew J, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha M, Chow, Benjamin JW, Cury, Ricardo C, Delago, Augustin, Gomez, Millie J, Hadamitzky, Martin, Hausleiter, Joerg, Hindoyan, Niree, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison M, Min, James K, and Kaufmann, Philipp A

Abstract

AimsCoronary 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 resultsThe 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.ConclusionIn 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.

Published
2015

145. A clinical model to identify patients with high-risk coronary artery disease.

Author

Yang, Yelin, Yang, Yelin, Chen, Li, Yam, Yeung, Achenbach, Stephan, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jörg, Karlsberg, Ronald P, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, LaBounty, Troy, Lin, Fay, Maffei, Erica, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, Min, James K, Chow, Benjamin JW, Yang, Yelin, Yang, Yelin, Chen, Li, Yam, Yeung, Achenbach, Stephan, Al-Mallah, Mouaz, Berman, Daniel S, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Cury, Ricardo, Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Hadamitzky, Martin, Hausleiter, Jörg, Karlsberg, Ronald P, Kaufmann, Philipp A, Kim, Yong-Jin, Leipsic, Jonathon, LaBounty, Troy, Lin, Fay, Maffei, Erica, Raff, Gilbert L, Shaw, Leslee J, Villines, Todd C, Min, James K, and Chow, Benjamin JW

Abstract

ObjectivesThis study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD).BackgroundAlthough current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify those patients with and without high-risk coronary anatomy.MethodsRetrospective analysis of a prospectively collected multinational coronary computed tomographic angiography (CTA) cohort was conducted. High-risk anatomy was defined as left main diameter stenosis ≥50%, 3-vessel disease with diameter stenosis ≥70%, or 2-vessel disease involving the proximal left anterior descending artery. Using a cohort of 27,125, patients with a history of CAD, cardiac transplantation, and congenital heart disease were excluded. The model was derived from 24,251 consecutive patients in the derivation cohort and an additional 7,333 nonoverlapping patients in the validation cohort.ResultsThe risk score consisted of 9 variables: age, sex, diabetes, hypertension, current smoking, hyperlipidemia, family history of CAD, history of peripheral vascular disease, and chest pain symptoms. Patients were divided into 3 risk categories: low (≤7 points), intermediate (8 to 17 points) and high (≥18 points). The model was statistically robust with area under the curve of 0.76 (95% confidence interval [CI]: 0.75 to 0.78) in the derivation cohort and 0.71 (95% CI: 0.69 to 0.74) in the validation cohort. Patients who scored ≤7 points had a low negative likelihood ratio (<0.1), whereas patients who scored ≥18 points had a high specificity of 99.3% and a positive likelihood ratio (8.48). In the validation group, the prevalence of high-risk CAD was 1% in patients with ≤7 points and 16.7% in those with ≥18 points.ConclusionsWe propose a scoring system, based on clinical variables, that can be used to identify patients at high and low pre-test probability of having high-risk CAD. Identification of these populations may detect

Published
2015

146. Gender differences in the prevalence, severity, and composition of coronary artery disease in the young: a study of 1635 individuals undergoing coronary CT angiography from the prospective, multinational confirm registry.

Author

Otaki, Yuka, Otaki, Yuka, Gransar, Heidi, Cheng, Victor Y, Dey, Damini, Labounty, Troy, Lin, Fay Y, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S, Min, James K, Otaki, Yuka, Otaki, Yuka, Gransar, Heidi, Cheng, Victor Y, Dey, Damini, Labounty, Troy, Lin, Fay Y, Achenbach, Stephan, Al-Mallah, Mouaz, Budoff, Matthew J, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Chow, Benjamin JW, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Joerg, Kaufmann, Philipp, Maffei, Erica, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Leipsic, Jonathon, Berman, Daniel S, and Min, James K

Abstract

ObjectivePrior studies examining coronary atherosclerosis in the young have been limited by retrospective analyses in small cohorts. We examined the relationship between cardiovascular risk factors (RFs) and prevalence and severity of coronary atherosclerosis in a large, prospective, multinational registry of consecutive young individuals undergoing coronary computerized tomographic angiography (CCTA).Method and resultsOf 27 125 patients undergoing CCTA, 1635 young (<45 years) individuals without known coronary artery disease (CAD) or coronary anomalies were identified. Coronary plaque was assessed for any CAD, obstructive CAD (≥50% stenosis), and presence of calcified plaque (CP) and non-calcified plaque (NCP). Among 1635 subjects (70% men, age 38 ± 6 years), any CAD, obstructive CAD, CP, and NCP were observed in 19, 4, 5, and 8%, respectively. Compared with women, men demonstrated higher rates of any CAD (21 vs. 12%, P < 0.001), CP (6 vs. 3%, P = 0.01), and NCP (9 vs. 5%, P = 0.008), although no difference was observed for rates of obstructive CAD (5 vs. 4%, P = 0.46). Any CAD, obstructive CAD, and NCP were higher for young individuals with diabetes, hypertension, dyslipidaemia, current smoking, or family history of CAD; while only diabetes and dyslipidaemia were associated with CP. Increasing cardiovascular RFs was associated with a greater prevalence and extent and severity of CAD, with individuals with 0, 1, 2, ≥3 RFs manifesting a dose-response increase in any CAD (P < 0.001, for trend), obstructive CAD (P < 0.001, for trend), NCP (P < 0.001, for trend), and CP (P < 0.001, for trend). In multivariable analysis adjusting for sex and cardiovascular RFs, male sex was the strongest predictor for any CAD (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.43-2.66, P < 0.001), CP (OR = 1.46, 95% CI = 1.08-1.98, P = 0.01), and NCP (OR = 1.33, 95% CI = 1.06-1.67, P = 0.01); family history of CAD was the strongest predictor for obstructive CA

Published
2015

147. Current but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiography.

Author

Nakanishi, Rine, Nakanishi, Rine, Berman, Daniel S, Budoff, Matthew J, Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Jörg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, Min, James K, Nakanishi, Rine, Nakanishi, Rine, Berman, Daniel S, Budoff, Matthew J, Gransar, Heidi, Achenbach, Stephan, Al-Mallah, Mouaz, Andreini, Daniele, Cademartiri, Filippo, Callister, Tracy Q, Chang, Hyuk-Jae, Cheng, Victor Y, Chinnaiyan, Kavitha, Chow, Benjamin JW, Cury, Ricardo, Delago, Augustin, Hadamitzky, Martin, Hausleiter, Jörg, Feuchtner, Gudrun, Kim, Yong-Jin, Kaufmann, Philipp A, Leipsic, Jonathon, Lin, Fay Y, Maffei, Erica, Pontone, Gianluca, Raff, Gilbert, Shaw, Leslee J, Villines, Todd C, Dunning, Allison, and Min, James K

Abstract

AimsWe evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA).Methods and resultsWe evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD): 10.6% vs. 14.9% vs. 15.2%, P < 0.001; 2-VD: 4.4% vs. 6.1% vs. 6.2%, P = 0.001; 3-VD: 3.1% vs. 5.2% vs. 4.3%, P < 0.001]. Compared with never smokers, current smokers experienced higher MACE risk [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.4-2.6, P < 0.001], while past smokers did not (HR 1.2, 95% CI 0.8-1.6, P = 0.35). Among matched individuals, current smokers had higher MACE risk (HR 2.6, 95% CI 1.6-4.2, P < 0.001), while past smokers did not (HR 1.3, 95% CI 0.7-2.4, P = 0.39). Similar findings were observed for risk of all-cause death.ConclusionAmong patients without known CAD undergoing CCTA, current and past smokers had increased burden of atherosclerosis compared with never smokers; however, risk of MACE was heightened only in current smokers.

Published
2015

148. Prognostic value of age adjusted segment involvement score as measured by coronary computed tomography: a potential marker of vascular age.

Author

Ayoub, Chadi, Kritharides, Leonard, Yam, Yeung, Chen, Li, Hossain, Alomgir, Achenbach, Stephan, Al-Mallah, Mouaz H., Andreini, Daniele, Berman, Daniel S., Budoff, Matthew J., Cademartiri, Filippo, Callister, Tracy Q., Chang, Hyuk-Jae, Chinnaiyan, Kavitha, Cury, Ricardo C., Delago, Augustin, Dunning, Allison, Feuchtner, Gudrun, Gomez, Millie, and Gransar, Heidi

Subjects
ATHEROSCLEROSIS, CORONARY disease, COMPUTED tomography, CORONARY angiography, PROGNOSIS
Abstract

Extent of coronary atherosclerotic disease (CAD) burden on coronary computed tomography angiography (CCTA) as measured by segment involvement score (SIS) has a prognostic value. We sought to investigate the incremental prognostic value of ‘age adjusted SIS’ (aSIS), which may be a marker of premature atherosclerosis and vascular age. Consecutive patients were prospectively enrolled into the CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicentre) multinational observational study. Patients were followed for the outcome of all-cause death. aSIS was calculated on CCTA for each patient, and its incremental prognostic value was evaluated. A total of 22,211 patients [mean age 58.5 ± 12.7 years, 55.8% male) with a median follow-up of 27.3 months (IQR 17.8, 35.4)] were identified. After adjustment for clinical factors and presence of obstructive CAD, higher aSIS was associated with increased death on multivariable analysis, with hazard ratio (HR) 2.40 (1.83-3.16, p < 0.001), C-statistic 0.723 (0.700-0.756), net reclassification improvement (NRI) 0.36 (0.26-0.47, p < 0.001), and relative integrated discrimination improvement (IDI) 0.33 (p = 0.009). aSIS had HR 3.48 (2.33-5.18, p < 0.001) for mortality in those without obstructive CAD, compared to HR 1.79 (1.25-2.58, p = 0.02) in those with obstructive CAD. In conclusion, aSIS has an incremental prognostic value to traditional risk factors and obstructive CAD, and may enhance CCTA risk stratification. [ABSTRACT FROM AUTHOR]

Published
2018
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149. Incremental prognostic value of coronary computed tomography angiography over coronary calciumscoring formajor adverse cardiac events in elderly asymptomatic individuals.

Author

Donghee Han, Hartaigh, Bríain Ó., Gransar, Heidi, Ji Hyun Lee, Rizvi, Asim, Baskaran, Lohendran, Schulman-Marcus, Joshua, Dunning, Allison, Achenbach, Stephan, Al-Mallah, Mouaz H., Berman, Daniel S., Budoff, Matthew J., Cademartiri, Filippo, Maffei, Erica, Callister, Tracy Q., Chinnaiyan, Kavitha, Chow, Benjamin J. W., DeLago, Augustin, Hadamitzky, Martin, and Hausleiter, Joerg

Subjects
CORONARY arterial radiography, AGE distribution, BLOOD vessels, CALCIUM, CARDIOVASCULAR diseases risk factors, COMPUTED tomography, CORONARY artery stenosis, CORONARY disease, MYOCARDIAL infarction, PROBABILITY theory, RISK assessment, SYMPTOMS, SEVERITY of illness index, PROGNOSIS
Abstract

Aims Coronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events beyond traditional risk assessment. Age is a risk factor with very high weight and little is known regarding the incremental value of CCTA over CAC for predicting cardiac events in older adults. Methods and results Of 27 125 individuals undergoing CCTA, a total of 3145 asymptomatic adults were identified. This study sample was categorized according to tertiles of age (cut-off points: 52 and 62 years). CAD severity was classified as 0, 1-49, and ≥50% maximal stenosis in CCTA, and further categorized according to number of vessels ≥50% stenosis. The Framingham 10-year risk score (FRS) and CACS were employed as major covariates. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death or non-fatal MI. During a median follow-up of 26 months (interquartile range: 18-41months), 59 (1.9%) MACE occurred. For patients in the top age tertile, CCTA improved discrimination beyond a model included FRS and CACS (C-statistic: 0.75 vs. 0.70, P-value= 0.015). Likewise, the addition of CCTA improved category-free net reclassification (cNRI) of MACE in patients within the highest age tertile (e.g. cNRI = 0.75; proportion of events/non-events reclassified were 50 and 25%, respectively; P-value <0.05, all). CCTA displayed no incremental benefit beyond FRS and CACS for prediction of MACE in the lower age tertiles. Conclusion CCTA provides added prognostic value beyond cardiac risk factors and CACS for the prediction of MACE in asymptomatic older adults. [ABSTRACT FROM AUTHOR]

Published
2018
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150. Incremental prognostic value of cardiac computed tomography in coronary artery disease using CONFIRM: COroNary computed tomography angiography evaluation for clinical outcomes: an InteRnational Multicenter registry

Author

Chow Benjamin J W, Small Gary, Yam Yeung, Chen Li, Achenbach Stephan, Al-Mallah Mouaz, Berman Daniel S, Budoff Matthew J, Cademartiri Filippo, Callister Tracy Q, Chang Hyuk-Jae, Cheng Victor, Chinnaiyan Kavitha M, Delago Augustin, Dunning Allison, Hadamitzky Martin, Hausleiter Jörg, Kaufmann Philipp, Lin Fay, Maffei Erica, Raff Gilbert L, Shaw Leslee J, Villines Todd C, Min James K, CONFIRM Investigators, University of Zurich, and Chow, B J W

Subjects
Male, medicine.medical_specialty, Time Factors, 610 Medicine & health, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Global Health, Risk Assessment, Severity of Illness Index, 2705 Cardiology and Cardiovascular Medicine, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Cause of Death, Severity of illness, 2741 Radiology, Nuclear Medicine and Imaging, Medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Proportional Hazards Models, Ejection fraction, business.industry, Incidence, Hazard ratio, 10181 Clinic for Nuclear Medicine, Middle Aged, medicine.disease, Prognosis, Confidence interval, 3. Good health, Transplantation, ROC Curve, Predictive value of tests, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Follow-Up Studies
Abstract

Background— Large multicenter studies validating the prognostic value of coronary computed tomographic angiography (CCTA) and left ventricular ejection fraction (LVEF) are lacking. We sought to confirm the independent and incremental prognostic value of coronary artery disease (CAD) severity measured using 64-slice CCTA over LVEF and clinical variables. Methods and Results— A large international multicenter registry (CONFIRM Registry) was queried, and CCTA patients with LVEF data on CCTA were screened. Patients with a history of myocardial infarction, coronary revascularization, or cardiac transplantation were excluded. The National Cholesterol Education Program-Adult Treatment Panel III risk was calculated for each patient, and CCTA was evaluated for CAD severity (normal, nonobstructive, non–high-risk, or high-risk CAD) and LVEF Conclusions— Our results demonstrate that CCTA measures of CAD severity and LVEF have independent prognostic value. Incorporation of CAD severity provides incremental value for predicting all-cause death over routine clinical predictors and LVEF in patients with suspected obstructive CAD.

Published
2011

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