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

A Aldrovandi, E Maffei, AA Palumbo, S Seitun, C Martini, V Brambilla, A Zuccarelli, G Tarantini, A.C. Weustink, Nico Mollet, L Ruffini, G Crisi, D Ardissino, Pim Feijter, Gabriel Krestin, F. Cademartiri

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Abstract

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 a parts per thousand currency sign50%) 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.
Original languageUndefined/Unknown
Pages (from-to)1653-1660
Number of pages8
JournalEuropean Radiology
Volume19
Issue number7
DOIs
Publication statusPublished - 2009

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