{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:22Z","timestamp":1792785862434,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:00:00Z","timestamp":1606867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institute of Health","award":["R01 HL115150"],"award-info":[{"award-number":["R01 HL115150"]}]},{"name":"Dalio Institute of Cardiovascular Imaging"},{"name":"Michael Wolk Foundation"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\u2003<\/jats:title>\n                    <jats:p>The relationship between dyspnoea, coronary artery disease (CAD), and major cardiovascular events (MACE) is poorly understood. This study evaluated (i) the association of dyspnoea with the severity of anatomical CAD by coronary computed tomography angiography (CCTA) and (ii) to which extent CAD explains MACE in patients with dyspnoea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results\u2003<\/jats:title>\n                    <jats:p>From the international COronary CT Angiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter (CONFIRM) registry, 4425 patients (750 with dyspnoea) with suspected but without known CAD were included and prospectively followed for \u22655\u2009years. First, the association of dyspnoea with CAD severity was assessed using logistic regression analysis. Second, the prognostic value of dyspnoea for MACE (myocardial infarction and death), and specifically, the interaction between dyspnoea and CAD severity was investigated using Cox proportional-hazard analysis. Mean patient age was 60.3\u2009\u00b1\u200911.9\u2009years, 63% of patients were male and 592 MACE events occurred during a median follow-up duration of 5.4 (IQR 5.1\u20136.0) years. On uni- and multivariable analysis (adjusting for age, sex, body mass index, chest pain typicality, and risk factors), dyspnoea was associated with two- and three-vessel\/left main (LM) obstructive CAD. The presence of dyspnoea increased the risk for MACE [hazard ratio (HR) 1.57, 95% confidence interval (CI): 1.29\u20131.90], which was modified after adjusting for clinical predictors and CAD severity (HR 1.26, 95% CI: 1.02\u20131.55). Conversely, when stratified by CAD severity, dyspnoea did not provide incremental prognostic value in one-, two-, or three-vessel\/LM obstructive CAD, but dyspnoea did provide incremental prognostic value in non-obstructive CAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion\u2003<\/jats:title>\n                    <jats:p>In patients with suspected CAD, dyspnoea was independently associated with severe obstructive CAD on CCTA. The severity of obstructive CAD explained the elevated MACE rates in patients presenting with dyspnoea, but in patients with non-obstructive CAD, dyspnoea portended additional risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaa323","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T07:36:48Z","timestamp":1605685008000},"page":"266-274","source":"Crossref","is-referenced-by-count":5,"title":["Associations between dyspnoea, coronary atherosclerosis, and cardiovascular outcomes: results from the long-term follow-up CONFIRM registry"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3088-433X","authenticated-orcid":false,"given":"Alexander R","family":"van Rosendael","sequence":"first","affiliation":[{"name":"Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA"},{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Maxim","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge J","family":"van den Hoogen","sequence":"additional","affiliation":[{"name":"Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff M","family":"Smit","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhi J","family":"Al\u2019Aref","sequence":"additional","affiliation":[{"name":"Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouaz H","family":"Al-Mallah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Andreini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Cardiologico Monzino, IRCCS Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S","family":"Berman","sequence":"additional","affiliation":[{"name":"Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Budoff","sequence":"additional","affiliation":[{"name":"Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Cademartiri","sequence":"additional","affiliation":[{"name":"Department of Radiology, Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy Q","family":"Callister","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tennessee Heart and Vascular Institute, Hendersonville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuk-Jae","family":"Chang","sequence":"additional","affiliation":[{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha","family":"Chinnaiyan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J W","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Medicine and Radiology, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo C","family":"Cury","sequence":"additional","affiliation":[{"name":"Department of Radiology, Miami Cardiac and Vascular Institute, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"DeLago","sequence":"additional","affiliation":[{"name":"Capitol Cardiology Associates, Albany, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Feuchtner","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hadamitzky","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Hausleiter","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medizinische Klinik I der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp A","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital, Zurich, Switzerland"},{"name":"Department of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Seoul National University Hospital, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon A","family":"Leipsic","sequence":"additional","affiliation":[{"name":"Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Maffei","sequence":"additional","affiliation":[{"name":"Department of Radiology, Area Vasta 1\/ASUR Marche, Urbino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Cardiology, UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"de Ara\u00fajo Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Cardiology, UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Pontone","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Cardiologico Monzino, IRCCS Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert L","family":"Raff","sequence":"additional","affiliation":[{"name":"Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Rubinshtein","sequence":"additional","affiliation":[{"name":"Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd C","family":"Villines","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiology Service, Walter Reed National Military Center, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Gransar","sequence":"additional","affiliation":[{"name":"Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Healthcare Policy and Research, New York-Presbyterian Hospital, The Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M","family":"Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fay 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