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

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.

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

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fabiola B Sozzi ◽  
Filippo Civaia ◽  
Laura Iacuzio ◽  
Stephan Russek ◽  
Philipe Rossi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Angiography ◽  
Prognostic Value ◽  
Suspected Coronary Artery Disease ◽  
Ct Coronary Angiography ◽  
Cardiac Events ◽  
Luminal Narrowing ◽  
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.

scholarly journals Prognostic Value of Atherosclerotic Extent in Diabetic Patients with Non-Obstructive Coronary Artery Disease

2020 ◽  
Author(s):  
Zinuan Liu ◽  
Yipu Ding ◽  
Guanhua Dou ◽  
Xia Yang ◽  
Xi Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Sensitivity Analysis ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Obstructive Coronary Artery Disease ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background: The prognostic value of non-obstructive CAD has always been underestimated due to its moderate stenosis. Whether the atherosclerotic extent is related to the prognosis in this group of people is uncertain, especially in the presence of diabetes. We aim to investigate the prognostic value of atherosclerotic extent in diabetic patients with non-obstructive coronary artery disease (CAD).Method: The analysis was based on a single center cohort of diabetic patients referred for coronary computed tomography angiography (CCTA) due to suspect CAD. Major adverse cardiac events (MACEs) were recorded, including cardiovascular death, non-fatal myocardial infarction, stroke and unstable angina (UA) requiring hospitalization. Four groups were defined based on coronary stenosis combined with segment involvement score (SIS), a semiquantitative index of the extent of atherosclerosis, including normal, non-obstructive SIS<3, non-obstructive SIS≥3 and obstructive. Time to event was estimated by using multivariable Cox proportional hazards models. Leidon risk score was used to replace SIS for sensitivity analysis.Results: In total, 1241 patients were included (age 60.2±10.4 years, 54.1% male), experiencing 131 MACEs (10.6%) during a median follow-up of 2.6 years. Diabetic patients with non-obstructive CAD accounts for 50.2% of included population（N=623）. In multi-variate Cox model adjusting for age, gender, hyperlipidemia and presence of high-risk plaque, hazard ratio (HR) for SIS < 3 and SIS ≥ 3 in non-obstructive CAD were 1.84 (95%CI: 0.70-4.79) and 3.71 (95%CI: 1.37-10.00) respectively.The latter showed a higher risk of cardiac adverse events than the former group（HR：2.02 95%CI:1.11-3.68, p＝0.021）, while HR for obstructive CAD was 5.46 (95%CI: 2.18-13.69). Sensitivity analysis was performed using Leidon Risk Score instead of SIS. After adjustment, HR for Leidon ≥ 5 with non-obstructive disease was 1.92（95% CI: 1.06-3.48 p=0.032）in comparison to the non-obstructive group of Leidon < 5.Conclusion: In diabetic patients with non-obstructive CAD, atherosclerotic extent was associated with higher risk of major adverse cardiac events at long-term follow-up. Efforts should be made to determine risk stratification for the management of DM patients with non-obstructive CAD.

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