Abstract 2235: Prognostic Value of 64 Slices Computed Tomography Coronary Angiography in Patients with Suspected Coronary Artery Disease

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.

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Prognostic value of normal and non-obstructive coronary artery disease based on CT angiography findings. A 12 month follow up study

Journal of Cardiovascular and Thoracic Research ◽

10.15171/jcvtr.2019.52 ◽

2019 ◽

Vol 11 (4) ◽

pp. 318-321

Author(s):

Amirreza Sajjadieh Khajouei ◽

Atoosa Adibi ◽

Zahra Maghsodi ◽

Majid Nejati ◽

Mohaddeseh Behjati

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Arteries ◽

Prognostic Value ◽

Significant Finding ◽

Cardiac Events ◽

Luminal Narrowing ◽

Artery Disease

Introduction: The advent of multi-slice computed tomography (CT) technology has provided a new promising tool for non-invasive assessment of the coronary arteries. However, as the prognostic outcome of patients with normal or non-significant finding on computed tomography coronary angiography (CTCA) is not well-known, this study was aimed to determine the prognostic value of CTCA in patients with either normal or non-significant CTCA findings.|<br /> Methods: This retrospective cohort study was performed on patients who were referred for CTCA to the hospital. 527 patients with known or suspected coronary artery disease (CAD), who had undergone CTCA within one year were enrolled. Among them, data of 465 patients who had normal (no stenosis, n=362) or non-significant CTCA findings (stenosis <50% of luminal narrowing, n=103) were analyzed and prevalence of cardiac risk factors and major adverse cardiac events (MACE) were compared between these groups. In addition, a correlation between these factors and the number of involved coronary arteries was also determined. <br /> Results: After a mean follow-up duration of 13.11±4.63 months, all cases were alive except for three patients who died by non-cardiac events. Prevalence of MACE was 0% and 3% in normal CTCA group and non-significant groups, respectively. There was no correlation found between the number of involved coronary arteries and the prevalence of MACE (P = 0.57). <br /> Conclusion: A normal CTCA could be associated with extremely low risk of MACE over the first year after the initial imaging, whereas non-significant obstruction in coronary arteries may be associated with a slightly higher risk of MACE.

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