{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:20:56Z","timestamp":1761844856843,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T00:00:00Z","timestamp":1525996800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL115150"],"award-info":[{"award-number":["R01 HL115150"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL115150"],"award-info":[{"award-number":["R01 HL115150"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>Our objective was to assess the prognostic value of symptom typicality in patients without obstructive coronary artery disease (CAD), determined by coronary computed tomographic angiography (CCTA). We identified 4215 patients without prior history of CAD and without obstructive CAD (&lt;50% CCTA stenosis). CAD severity was categorized as nonobstructive (1%\u201349%) and none (0%). Based upon the Diamond\u2010Forrester criteria for angina pectoris, symptom typicality was classified as asymptomatic, nonanginal, atypical, and typical. Multivariable Cox proportional hazards models were used to assess the risk of major adverse cardiac events (MACE), comprising all\u2010cause mortality, myocardial infarction, unstable angina, and late revascularization, according to symptom typicality. Mean patient age was 57.0\u2009\u00b112.0\u2009years (54.9% male). During a median follow\u2010up of 5.3\u2009years (interquartile range, 4.6\u20135.9\u2009years), MACE were reported in 312 (7.4%) patients. Among patients with nonobstructive CAD, there was an association between symptom typicality and MACE (<jats:italic>P<\/jats:italic> for interaction\u2009=\u20090.05), driven by increased risk of MACE among those with typical angina and nonobstructive CAD (hazard ratio: 1.62, 95% confidence interval: 1.06\u20132.48, <jats:italic>P<\/jats:italic>\u2009=\u20090.03). No consistent relationship was found between symptom typicality and MACE among patients without any CAD (hazard ratio: 0.73, 95% confidence interval: 0.34\u20131.57, <jats:italic>P<\/jats:italic>\u2009=\u20090.08). In the CONFIRM registry, patients who presented with concomitant typical angina and nonobstructive CAD had a higher rate of MACE than did asymptomatic patients with nonobstructive CAD. However, the presence of typical angina did not appear to portend worse prognosis in patients with no CAD.<\/jats:p>","DOI":"10.1002\/clc.22940","type":"journal-article","created":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T11:06:38Z","timestamp":1520593598000},"page":"586-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Influence of symptom typicality for predicting MACE in patients without obstructive coronary artery disease: From the CONFIRM Registry (Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry)"],"prefix":"10.1002","volume":"41","author":[{"given":"Ji Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"},{"name":"Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute Yonsei University College of Medicine, Yonsei University Health System  Seoul South Korea"},{"name":"Division of Cardiology, Department of Internal Medicine Myongji Hospital  Goyang\u2010si South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghee","family":"Han","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"},{"name":"Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute Yonsei University College of Medicine, Yonsei University Health System  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Br\u00edain \u00f3","family":"Hartaigh","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Gransar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Myongji Hospital  Goyang\u2010si South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Lu","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asim","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahn Won","family":"Park","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadi Mirhedayati","family":"Roudsari","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wijnand J.","family":"Stuijfzand","sequence":"additional","affiliation":[{"name":"Dalio Institute of Cardiovascular Imaging, Department of Radiology New York\u2013Presbyterian Hospital and Weill Cornell Medicine  New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S.","family":"Berman","sequence":"additional","affiliation":[{"name":"Department of Imaging Cedars\u2010Sinai Medical Center  Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Q.","family":"Callister","sequence":"additional","affiliation":[{"name":"Tennessee Heart and Vascular Institute  Hendersonville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustin","family":"DeLago","sequence":"additional","affiliation":[{"name":"Capitol Cardiology Associates  Albany New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Hadamitzky","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine German Heart Center Munich  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joerg","family":"Hausleiter","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I der Ludwig\u2010Maximilians\u2010Universit\u00e4t M\u00fcnchen  Munich 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