title: Age- and gender-specific differences in the prognostic value of CT coronary angiography.
abstract: OBJECTIVE
  To evaluate the potential age- and gender-specific differences in the incidence and prognostic value of coronary artery disease (CAD) in patients undergoing CT coronary angiography (CTA).
  
  
  METHODS
  In this multicentre prospective registry study, 2432 patients (mean age 57 ± 12, 56% male) underwent CTA for suspected CAD. Patients were stratified into four groups according to age <60 or ≥60 years and, male or female gender.
  
  
  METHODS
  A composite end point of cardiac death and non-fatal myocardial infarction.
  
  
  RESULTS
  CTA results were normal in 991 (41%) patients, showed non-significant CAD in 761 (31%) patients and significant CAD in the remaining 680 (28%) patients. During follow-up (median 819 days, 25-75th centile 482-1142) a cardiovascular event occurred in 59 (2.4%) patients. The annualised event rate was 1.1% in the total population (men=1.3% and women=0.9%). In patients aged <60 years, the annualised event rate of male and female patients was 0.6% and 0.5%, respectively. Among patients aged ≥60 years the annualised event rate was 1.9% in male and 1.1% in female patients. Observations on CTA predicted events in male patients, both age <60 and ≥60 years and in female patients age ≥60 years (log-rank test in all groups, p<0.01). However, CTA provided limited prognostic value in female patients aged <60 years (log-rank test, p=0.45).
  
  
  CONCLUSIONS
  After age and gender stratification, CTA findings were shown to be of limited predictive value in female patients aged <60 years as compared with male patients at any age and female patients aged ≥60 years.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, The Netherlands.
authors.forename: Kai Hang
authors.initials: KH
authors.lastname: Yiu
authors.forename: Fleur R
authors.initials: FR
authors.lastname: de Graaf
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Jacob M
authors.initials: JM
authors.lastname: van Werkhoven
authors.forename: Nina Ajmone
authors.initials: NA
authors.lastname: Marsan
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Veltman
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Aju
authors.initials: A
authors.lastname: Pazhenkottil
authors.forename: Lucia J
authors.initials: LJ
authors.lastname: Kroft
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Bernhard
authors.initials: B
authors.lastname: Herzog
authors.forename: Melissa
authors.initials: M
authors.lastname: Leung
authors.forename: Erica
authors.initials: E
authors.lastname: Maffei
authors.forename: Dominic Y
authors.initials: DY
authors.lastname: Leung
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D014057:Tomography, X-Ray Computed