Prognostic value of dual-source computed tomography (DSCT) angiography characteristics in anomalous coronary artery from the opposite sinus (ACAOS) patients: a large-scale retrospective study.
Background: Most reported cases of right anomalous coronary artery from the opposite sinus (R-ACAOS) have benign clinical outcomes. However, patients with left ACAOS (L-ACAOS) and some of the patients with R-ACAOS are more at risk for arrhythmias and sudden cardiac death, which remains a major conce...
| Publicado en: | BMC Cardiovascular Disorders Vol. 20; no. 1; pp. 1 - 13 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
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BioMed Central
1/17/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141252854&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141252854 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712261 1CHA jtl: BMC Cardiovascular Disorders issn: 14712261 maglogo: N pubinfo: dt: 1/17/2020 vid: 20 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 141252854 141252854 NLM31952479 141252854 10.1186/s12872-019-01285-3 NLM31952479 141252854 ppf: 1 ppct: 12 formats: tig: atl: Prognostic value of dual-source computed tomography (DSCT) angiography characteristics in anomalous coronary artery from the opposite sinus (ACAOS) patients: a large-scale retrospective study. aug: au: Diao, Kai-yue Zhao, Qin Gao, Yue Shi, Ke Ma, Min Xu, Hua-yan Guo, Ying-kun Yang, Zhi-gang affil: Department of Radiology, State Key Laboratory of Biotherapy West China Hospital, Sichuan University, No.37 Guoxue Xiang, 610041, Chengdu, China sug: subj: Coronary Vessel Anomalies Coronary Vessels Coronary Stenosis Coronary Angiography Coronary Vessels Abnormalities Severity of Illness Indices Prognosis Coronary Vessel Anomalies Epidemiology Coronary Vessel Anomalies Therapy Incidence Retrospective Design Aged Middle Age Female China Time Factors Human Adult Coronary Stenosis Epidemiology Prevalence Risk Factors Risk Assessment Coronary Stenosis Therapy Male Predictive Value of Tests Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Aged: 65+ years Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Background: Most reported cases of right anomalous coronary artery from the opposite sinus (R-ACAOS) have benign clinical outcomes. However, patients with left ACAOS (L-ACAOS) and some of the patients with R-ACAOS are more at risk for arrhythmias and sudden cardiac death, which remains a major concern. Here we report the prevalence and anatomical features of ACAOS patients. Moreover, we explore the high-risk morphological signs and evaluate their mid-term prognostic value in R-ACAOS patients without surgical intervention.Methods: Data from coronary computed tomography angiography (CTA) of 30,593 patients, pertaining to a single center over 5 consecutive years, were retrospectively analyzed. The image analysis included stenosis severity ranking and high-risk anatomy evaluation, based on the commercially available image post-processing software OsirX. Patients with R-ACAOS and without evidence of coronary atherosclerosis (CAD) were followed-up, with recording of the cardiovascular clinical events. Cox regression analysis was performed to identify the potential anatomical risk factors of cardiovascular clinical events for non-CAD R-ACAOS patients, using R project.Results: The prevalence of ACAOS in the study population was 0.69% (211/30593). Significant differences were found between patients with mild (< 50%) and severe (> 50%) stenosis, in terms of height-to-weight ratio (HW ratio), take-off angle, and proximal stenosis length. A total of 54 cardiovascular clinical events were observed among 108 non-CAD R-ACAOS patients and an average follow-up of 27.8 ± 18.7 months. Among those patients' anatomical features, stenosis severity was the main risk factor for cardiovascular clinical events during the mid-term follow-up, with a risk ratio of 4.14 (95% CI: 1.78 to 9.63, P < 0.001).Conclusions: Among patients referred to coronary CTA, the overall incidence of ACAOS was 0.69%. For patients with R-ACAOS, severe stenosis was the independent risk factor of adverse clinical events in the mid-term follow-up, and positive clinical intervention might be needed to help them avoid the malignant clinical events. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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