Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort

LettersOctober 2023Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish CohortMatthew J. Budoff, MD, Khurram Nasir, MD, MPH, MSc, Michael J. Blaha, MD, MPHMatthew J. Budoff, MDLundquist Institute at Harbor–UCLA, Torrance, CaliforniaSearch for more papers by this author, Khurram Nasir, MD, MPH, MScHouston Methodist Hospital, Houston, TexasSearch for more papers by this author, Michael J. Blaha, MD, MPHJohns Hopkins School of Medicine, Baltimore, MarylandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0262 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: We read with interest Fuchs and colleagues' study (1) on the use of coronary computed tomography angiography (CTA), because data on outcomes after this study in asymptomatic cohorts are limited. We applaud the authors for their large and robust study with blinding to coronary CTA results, which ensured approximation of a natural history study.Following 9533 asymptomatic participants for 3.5 years, the authors show that both extensive plaque and obstructive coronary artery disease (evaluated using visual assessment) are predictors of myocardial infarction and mortality. They lay the groundwork for use of coronary CTA for risk stratification of ...References1. Fuchs A, Kühl JT, Sigvardsen PE, et al. Subclinical coronary atherosclerosis and risk for myocardial infarction in a Danish cohort. A prospective observational cohort study. Ann Intern Med. 2023;176:433-442. [PMID: 36972540] doi:10.7326/M22-3027 LinkGoogle Scholar2. Al’Aref SJ, Maliakal G, Singh G, et al. Machine learning of clinical variables and coronary artery calcium scoring for the prediction of obstructive coronary artery disease on coronary computed tomography angiography: analysis from the CONFIRM registry. Eur Heart J. 2020;41:359-367. [PMID: 31513271] doi:10.1093/eurheartj/ehz565 CrossrefMedlineGoogle Scholar3. Cho I, Chang HJ, Sung JM, et al; CONFIRM Investigators. Coronary computed tomographic angiography and risk of all-cause mortality and nonfatal myocardial infarction in subjects without chest pain syndrome from the CONFIRM Registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry). Circulation. 2012;126:304-13. [PMID: 22685117] doi:10.1161/CIRCULATIONAHA.111.081380 CrossrefMedlineGoogle Scholar4. Williams MC, Moss AJ, Dweck M, et al. Coronary artery plaque characteristics associated with adverse outcomes in the SCOT-HEART study. J Am Coll Cardiol. 2019;73:291-301. [PMID: 30678759] doi:10.1016/j.jacc.2018.10.066 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Matthew J. Budoff, MD; Khurram Nasir, MD, MPH, MSc; Michael J. Blaha, MD, MPHAffiliations: Lundquist Institute at Harbor–UCLA, Torrance, CaliforniaHouston Methodist Hospital, Houston, TexasJohns Hopkins School of Medicine, Baltimore, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0262. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSubclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort Andreas Fuchs , Jørgen Tobias Kühl , Per Ejlstrup Sigvardsen , Shoaib Afzal , Andreas Dehlbæk Knudsen , Mathias Bech Møller , Martina Chantal de Knegt , Mathias Holm Sørgaard , Børge Grønne Nordestgaard , Lars Valeur Køber , and Klaus Fuglsang Kofoed Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort Klaus Fuglsang Kofoed , Andreas Fuchs , Lars Valeur Køber Metrics October 2023Volume 176, Issue 10 Keywords Angiography Atherosclerosis Cohort studies Computed axial tomography Coronary heart disease Hazard ratio Muscular dystrophies Myocardial infarction Stable coronary artery disease Stenosis ePublished: 17 October 2023 Issue Published: October 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...