title: Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease.
abstract: The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 +/- 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 +/- 4 months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions (> or =50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis.
authors.affiliation: Cardiovascular Center, University Hospital Zurich NUK C 32, Ramistrasse 100, CH-8091 Zurich, Switzerland. oliver.gaemperli@usz.ch
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Ines
authors.initials: I
authors.lastname: Valenta
authors.forename: Tiziano
authors.initials: T
authors.lastname: Schepis
authors.forename: Lars
authors.initials: L
authors.lastname: Husmann
authors.forename: Hans
authors.initials: H
authors.lastname: Scheffel
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol