To assess the value of 64-slice computed tomography (CT) coronary angiography for the risk stratification in patients with suspected coronary artery disease (CAD). The prognostic value of 64-slice CT is still unknown. A total of 205 patients (129 men [63%], age 61±10 years) who were referred for further cardiac evaluation due to suspicion of CAD underwent 64-slice CT to evaluate the presence and severity of CAD. It was determined weather the lesion was obstructive or not using a threshold of 50% luminal narrowing. Plaques were classified in calcificed, soft and mixed based on type. End-point during follow-up was hard cardiac events (non-fatal myocardial infarction, unstable angina requiring hospitalization, myocardial revascularization). Coronary plaques were detected in 150 (73%) patients. During a mean follow-up period of 30 months, 83 events occurred in 44 patients. Event-free survival curves in patients with obstructive and non-obstructive lesions respectively and in patients with normal lumen are presented in figure
. In patients with normal coronary arteries, the 30-month event rate was 0% versus 46% in patients with significant obstructions (≥50% luminal narrowing) (p <0.001), and 9% in patients with non-significant lesions (<50% luminal narrowing). In multivariate analysis, significant predictors of cardiac events were age, hypercholesterolemia, presence of CAD, obstructive CAD, number of segments with obstructive plaques and obstructive soft plaques. 64-slice CT coronary angiography provides independent prognostic informations over baseline clinical risk factors in patients with suspected CAD.
Prognostic value of CT coronary angiography in diabetic and non-diabetic subjects with suspected CAD: importance of presenting symptoms