title: Non-obstructive coronary artery disease upon multi-detector computed tomography in patients presenting with acute chest pain--results of an intermediate term follow-up.
abstract: OBJECTIVE
  Multi-detector computed tomography (MDCT) has emerged as an efficient tool for detection of obstructive coronary artery disease (CAD) and assessment of patients with acute chest pain. MDCT may detect premature, non-obstructive atherosclerotic lesions which otherwise would have not been detected upon functional cardiac imaging tests. Currently, there is scarce data regarding the clinical significance of these lesions. The purpose of this study was to prospectively analyse the intermediate term outcome of patients admitted to chest pain unit (CPU) with findings of non-obstructive CAD upon MDCT. Method and results The study comprised 444 patients admitted to the CPU at Sheba Medical Center and underwent evaluation by MDCT for complaints of acute chest pain. Studies were classified as: normal; non-obstructive CAD (defined as any narrowing <50% diameter stenosis); obstructive CAD (narrowing of ≥ 50% diameter stenosis); or non-diagnostic. Patients were followed up for a minimum of 1 year and outcomes were compared between the non-obstructive (n = 115) and the normal (n = 266) MDCT groups in regard to MACE [coronary revascularization, acute coronary syndrome (ACS), and death]. Comparing the groups, those with non-obstructive CAD were older, more likely to be males, and dyslipidaemic. During an intermediate term follow-up (2.5 ± 0.4 years) MACE was equally low between the two groups (1% for both groups; P = 0.9).
  
  
  CONCLUSIONS
  Among patients evaluated by MDCT for acute chest pain, during an intermediate term follow-up, those with non-obstructive CAD had a benign clinical outcome compared with those with normal coronary arteries.
authors: Leviev Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer 52561, Israel. amit.segev@sheba.health.gov.il
authors: Amit
authors: A
authors: Segev
authors: Roy
authors: R
authors: Beigel
authors: Orly
authors: O
authors: Goitein
authors: Sella
authors: S
authors: Brosh
authors: Dan
authors: D
authors: Oiero
authors: Eli
authors: E
authors: Konen
authors: Hanoch
authors: H
authors: Hod
authors: Shlomi
authors: S
authors: Matetzky
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index