title: Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering.
abstract: OBJECTIVE
  To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective ECG triggering in a patient population with known or suspected coronary artery disease (CAD).
  
  
  METHODS
  Longitudinal follow-up study.
  
  
  METHODS
  Tertiary referral cardiac imaging centre.
  
  
  METHODS
  434 consecutive patients who were referred for evaluation of CAD by CCTA.
  
  
  METHODS
  The presence, distribution and severity of coronary lesions (non-obstructive <50% vs obstructive ≥50% luminal narrowing) were recorded by low-dose prospective ECG-triggered CCTA for each patient. The prognostic value of low-dose CCTA to predict major adverse cardiac events, defined as cardiac death, non-fatal myocardial infarction, or the need for revascularisation, was assessed using multivariate Cox regression analysis. Each person was followed up by telephone interviews and/or on the basis of clinical records. Thirty-eight early revascularised patients were excluded from outcome analysis.
  
  
  RESULTS
  Completely normal coronary arteries were documented in 171 patients (47%), while exclusively non-obstructive lesions were found in 66 (18%), and obstructive coronary lesions were diagnosed in 130 patients (35%). A mean follow-up of 47±16 weeks was obtained. The first-year event rate was 0% in patients with normal coronary arteries on CCTA but increased to 3% and 26% in patients with non-obstructive and obstructive coronary artery lesions, respectively. In multivariate Cox regression analysis, a significant predictor of events was the presence of obstructive or any coronary lesions. Mean effective radiation dose was 1.8±0.6 mSv.
  
  
  CONCLUSIONS
  These data document an excellent prognostic performance of low-dose CCTA.
authors.affiliation: Department of Radiology, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Ronny R
authors.initials: RR
authors.lastname: Buechel
authors.forename: Aju P
authors.initials: AP
authors.lastname: Pazhenkottil
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Herzog
authors.forename: Michael
authors.initials: M
authors.lastname: Brueckner
authors.forename: Rene
authors.initials: R
authors.lastname: Nkoulou
authors.forename: Jelena R
authors.initials: JR
authors.lastname: Ghadri
authors.forename: Silke M
authors.initials: SM
authors.lastname: Küest
authors.forename: Christophe A
authors.initials: CA
authors.lastname: Wyss
authors.forename: Lars
authors.initials: L
authors.lastname: Husmann
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*