Prognostic value of computed tomography coronary angiography in patients with suspected coronary artery disease: a 24-month follow-up study

• Published in: European radiology 2009-07, Vol.19 (7), p.1653-1660
• Main Authors: Aldrovandi, Annachiara, Maffei, Erica, Palumbo, Alessandro, Seitun, Sara, Martini, Chiara, Brambilla, Valerio, Zuccarelli, Alessandra, Tarantini, Giuseppe, Weustink, Annick C., Mollet, Nico R., Ruffini, Livia, Crisi, Girolamo, Ardissino, Diego, de Feyter, Pim J., Krestin, Gabriel P., Cademartiri, Filippo
• Format: Article
• Language: English
• Subjects: Aged; Angina pectoris; Blood pressure; Cardiac; Cardiology; Cardiovascular disease; Coronary Angiography - statistics & numerical data; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary vessels; Diagnostic Radiology; Dyspnea; Female; Follow-Up Studies; Heart attacks; Humans; Imaging; Incidence; Internal Medicine; Interventional Radiology; Italy - epidemiology; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Pharmacists; Prognosis; Radiology; Reproducibility of Results; Sensitivity and Specificity; Survival Analysis; Survival Rate; Tomography; Tomography, X-Ray Computed - statistics & numerical data; Ultrasound; Vein & artery diseases
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-009-1344-3

The aim of this study was to determine the predictive value of 64-slice computed tomography coronary angiography (CTCA) for major cardiac events in patients with suspected coronary artery disease (CAD). A total of 187 consecutive patients (119 men, age 62.5 ± 10.5 years) without known heart disease underwent single-source 64-slice CTCA (Somatom Sensation 64, Siemens) for clinical suspicion of CAD. Patients underwent follow-up for the occurrence of cardiac death, nonfatal myocardial infarction, unstable angina and cardiac revascularization. In total, 2,822 coronary segments were assessed. Forty-two segments (1.5%) were not assessable because of insufficient image quality. Overall, CTCA revealed absence of CAD in 65 (34.7%) patients, nonobstructive CAD (coronary plaque ≤50%) in 87 (46.5%) patients and obstructive CAD (>50%) in 35 (18.8%) patients. A total of 20 major cardiac events (3 myocardial infarctions, 16 cardiac revascularizations, 1 unstable angina) occurred during a mean follow-up of 24 months. One noncardiac death occurred. Seventeen events occurred in the group of patients with obstructive CAD and three events occurred in the group of nonobstructive CAD. The event rate was 0% among patients with normal coronary arteries at CTCA. CTCA has a 100% negative predictive value for major cardiac events at 24-month follow-up in patients with normal coronary arteries.