Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort : A Prospective Observational Cohort Study
Authors' conclusion
In asymptomatic persons, subclinical, obstructive coronary atherosclerosis is associated with a more than 8-fold elevated risk for myocardial infarction.
Study context
- Population
- Asymptomatic persons aged ≥40 years without known ischemic heart disease, Copenhagen General Population Study, Denmark; assessed by coronary CT angiography
- Participants
- 9,533 persons
- Exposure
- Subclinical coronary atherosclerosis vs none
- No atherosclerosisn = 5,114reference
- Nonobstructiven = 3,483
- Obstructiven = 936
- Outcome
- Myocardial infarction
- Follow-up
- Median 3.5 years
Methodological detailsobservational, Coronary CT angiography conducted blinded to treatment and outcomes
- Observational
- Coronary CT angiography conducted blinded to treatment and outcomes
Main finding
As reported in the abstract
MI · median 3.5 years
Each group vs no atherosclerosisAdjusted relative risk (95% CI)
Obstructive
9.19(4.49–18.11)
Extensive
7.65(3.53–16.57)
Obstructive-extensive
12.48(5.50–28.12)
Obstructive-nonextensive
8.28(3.75–18.32)
- Persons with MI
- 71
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted RR (CI) | |
|---|---|---|
| Death or MI (composite)Nonobstructive-extensivevs No atherosclerosis | 2.70 (1.72–4.25) | |
| Death or MI (composite)Obstructive-extensivevs No atherosclerosis | 3.15 (2.05–4.83) | |
| 0.20.5125Adjusted relative risk (log scale) |
- Death or MI (composite) — Deaths
- 193
Death or MI (composite)
- Risk increased with extensive disease regardless of degree of obstruction
Original publication
Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort : A Prospective Observational Cohort Study. Ann Intern Med. Published 28 March 2023. doi:10.
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