title: Long-term follow-up of patients with first-time chest pain having 64-slice computed tomography.
abstract: A paucity of data on outcome of coronary multislice computed tomography (CT) is available. The aim of this study was to assess the long-term follow-up of 64-slice CT in a homogenous patient group. In total 222 patients (136 men, 61%, 59 ± 11 years of age) with chest pain at intermediate risk of coronary artery disease (CAD) and no previous CAD underwent 64-slice CT. Coronary lesions were considered significant or not based on a threshold of 50% luminal narrowing. Plaques were classified as calcified, noncalcified, and mixed based on type. End point during follow-up was major adverse cardiac events (nonfatal myocardial infarction, unstable angina requiring hospitalization, myocardial revascularization). Coronary plaques were detected in 162 patients (73%). Coronary artery stenosis was significant in 62 patients. Normal arteries were found in 59 patients (27%). During a mean follow-up of 5 ± 0.5 years, 30 cardiac events occurred. Annualized event rates were 0% in patients with normal coronary arteries, 1.2% in patients with nonsignificant stenosis, and 4.2% in patients with significant stenosis (p <0.01). Predictors of cardiac events were presence of significant stenosis, proximal stenosis, and multivessel disease. Noncalcified and mixed plaques had the worse prognosis (p <0.05). In conclusion, 64-CT provides long-term incremental value in patients at intermediate risk of CAD.
authors.affiliation: Monaco Cardiothoracic Centre, Monte Carlo, Monaco. fabiola_sozzi@yahoo.it
authors.forename: Fabiola B
authors.initials: FB
authors.lastname: Sozzi
authors.forename: Filippo
authors.initials: F
authors.lastname: Civaia
authors.forename: Philippe
authors.initials: P
authors.lastname: Rossi
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Robillon
authors.forename: Stephane
authors.initials: S
authors.lastname: Rusek
authors.forename: Frederic
authors.initials: F
authors.lastname: Berthier
authors.forename: Francois
authors.initials: F
authors.lastname: Bourlon
authors.forename: Laura
authors.initials: L
authors.lastname: Iacuzio
authors.forename: Gilles
authors.initials: G
authors.lastname: Dreyfus
authors.forename: Vincent
authors.initials: V
authors.lastname: Dor
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging; D002637:Chest Pain / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed