Abstract
BackgroundSmall case series have associated coronary myocardial bridging (MB) with adverse cardiac events. However, the clinical significance of MB in unselected patients with chest pain remains unclear. The purpose of this study was to explore the relation between the presence of isolated MB and subsequent adverse cardiac events in symptomatic patients referred for coronary computed tomography angiography (CCTA).Methods and resultsThree hundred and thirty-four consecutive patients (age 57 ± 13 years, 43% female) with chest pain and no prior history of coronary artery disease (CAD) who underwent 64-slice CCTA and had no obstructive CAD (≥50% coronary luminal obstruction) were included. Patients were followed for cardiac events [cardiovascular (CV) death or non-fatal myocardial infarction (MI)] over 6.1 ± 1 years. Outcomes were compared between patients with MB vs. those without MB using the Cox models. MB was present in 117 out of 334 (35%) patients on CCTA and 80% of MB involved the mid-distal left anterior descending coronary artery. During a mean follow-up duration of 6.1 ± 1 years, cardiac events occurred in 6 out of 117 (5.1%) patients with, and 7 out of 217 (3.2%) patients without MB (P = 0.40). Univariate predictors of cardiac events were hypertension [hazards ratio (HR) = 10.6, P = 0.002], diabetes mellitus (HR = 4.8, P = 0.01), and older age (HR = 1.1, P = 0.0004). The association of hypertension and age with adverse cardiac events remained statistically significant after adjusting for other variables. Neither the presence nor the extent of MB was associated with an increased risk of cardiac events.ConclusionMB is a common finding on CCTA among patients presenting with chest pain but no obstructive CAD. No association was evident between MB and the risk of CV death or MI. Published on behalf of the European Society of Cardiology. All rights reserved.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 579-585 |
| Number of pages | 7 |
| Journal | European Heart Journal Cardiovascular Imaging |
| Volume | 14 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2013 |
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Keywords
- Coronary artery disease
- Coronary computed tomography angiography
- Myocardial bridging
- Prognosis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Long-term prognosis and outcome in patients with a chest pain syndrome and myocardial bridging : A 64-slice coronary computed tomography angiography study. / Rubinshtein, Ronen; Gaspar, Tamar; Lewis, Basil S.; Prasad, Abhiram; Peled, Nathan; Halon, David A.
In: European Heart Journal Cardiovascular Imaging, Vol. 14, No. 6, 06.2013, p. 579-585.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term prognosis and outcome in patients with a chest pain syndrome and myocardial bridging
T2 - A 64-slice coronary computed tomography angiography study
AU - Rubinshtein, Ronen
AU - Gaspar, Tamar
AU - Lewis, Basil S.
AU - Prasad, Abhiram
AU - Peled, Nathan
AU - Halon, David A.
PY - 2013/6
Y1 - 2013/6
N2 - BackgroundSmall case series have associated coronary myocardial bridging (MB) with adverse cardiac events. However, the clinical significance of MB in unselected patients with chest pain remains unclear. The purpose of this study was to explore the relation between the presence of isolated MB and subsequent adverse cardiac events in symptomatic patients referred for coronary computed tomography angiography (CCTA).Methods and resultsThree hundred and thirty-four consecutive patients (age 57 ± 13 years, 43% female) with chest pain and no prior history of coronary artery disease (CAD) who underwent 64-slice CCTA and had no obstructive CAD (≥50% coronary luminal obstruction) were included. Patients were followed for cardiac events [cardiovascular (CV) death or non-fatal myocardial infarction (MI)] over 6.1 ± 1 years. Outcomes were compared between patients with MB vs. those without MB using the Cox models. MB was present in 117 out of 334 (35%) patients on CCTA and 80% of MB involved the mid-distal left anterior descending coronary artery. During a mean follow-up duration of 6.1 ± 1 years, cardiac events occurred in 6 out of 117 (5.1%) patients with, and 7 out of 217 (3.2%) patients without MB (P = 0.40). Univariate predictors of cardiac events were hypertension [hazards ratio (HR) = 10.6, P = 0.002], diabetes mellitus (HR = 4.8, P = 0.01), and older age (HR = 1.1, P = 0.0004). The association of hypertension and age with adverse cardiac events remained statistically significant after adjusting for other variables. Neither the presence nor the extent of MB was associated with an increased risk of cardiac events.ConclusionMB is a common finding on CCTA among patients presenting with chest pain but no obstructive CAD. No association was evident between MB and the risk of CV death or MI. Published on behalf of the European Society of Cardiology. All rights reserved.
AB - BackgroundSmall case series have associated coronary myocardial bridging (MB) with adverse cardiac events. However, the clinical significance of MB in unselected patients with chest pain remains unclear. The purpose of this study was to explore the relation between the presence of isolated MB and subsequent adverse cardiac events in symptomatic patients referred for coronary computed tomography angiography (CCTA).Methods and resultsThree hundred and thirty-four consecutive patients (age 57 ± 13 years, 43% female) with chest pain and no prior history of coronary artery disease (CAD) who underwent 64-slice CCTA and had no obstructive CAD (≥50% coronary luminal obstruction) were included. Patients were followed for cardiac events [cardiovascular (CV) death or non-fatal myocardial infarction (MI)] over 6.1 ± 1 years. Outcomes were compared between patients with MB vs. those without MB using the Cox models. MB was present in 117 out of 334 (35%) patients on CCTA and 80% of MB involved the mid-distal left anterior descending coronary artery. During a mean follow-up duration of 6.1 ± 1 years, cardiac events occurred in 6 out of 117 (5.1%) patients with, and 7 out of 217 (3.2%) patients without MB (P = 0.40). Univariate predictors of cardiac events were hypertension [hazards ratio (HR) = 10.6, P = 0.002], diabetes mellitus (HR = 4.8, P = 0.01), and older age (HR = 1.1, P = 0.0004). The association of hypertension and age with adverse cardiac events remained statistically significant after adjusting for other variables. Neither the presence nor the extent of MB was associated with an increased risk of cardiac events.ConclusionMB is a common finding on CCTA among patients presenting with chest pain but no obstructive CAD. No association was evident between MB and the risk of CV death or MI. Published on behalf of the European Society of Cardiology. All rights reserved.
KW - Coronary artery disease
KW - Coronary computed tomography angiography
KW - Myocardial bridging
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84877966742&partnerID=8YFLogxK
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U2 - 10.1093/ehjci/jet010
DO - 10.1093/ehjci/jet010
M3 - Article
VL - 14
SP - 579
EP - 585
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 6
ER -