title: Value of coronary computed tomography as a prognostic tool.
abstract: Coronary computed tomography angiography (CCTA) has become an important part of our armamentarium for noninvasive diagnosis of coronary artery disease (CAD). Emerging technologies have produced lower radiation dose, improved spatial and temporal resolution, as well as information about coronary physiology. Although the prognostic role of coronary artery calcium scoring is known, similar evidence for CCTA has only recently emerged. Initial, small studies in various patient populations have indicated that CCTA-identified CAD may have a prognostic value. These findings were confirmed in a recent analysis of the international, prospective Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter (CONFIRM) registry. An incremental increase in mortality was found with a worse severity of CAD on a per-patient, per-vessel, and per-segment basis. In addition, age-, sex-, and ethnicity-based differences in mortality were also found. Whether changing our management algorithms based on these findings will affect outcomes is unclear. Large prospective studies utilizing targeted management strategies for obstructive and nonobstructive CAD are required to incorporate these recent findings into our daily practice.
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, Pennsylvania 18103, USA.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Contractor
authors.forename: Maansi
authors.initials: M
authors.lastname: Parekh
authors.forename: Shameer
authors.initials: S
authors.lastname: Ahmed
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Martinez
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D002637:Chest Pain; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology; D006305:Health Status Indicators; D006801:Humans; D011379:Prognosis; D012042:Registries; D014057:Tomography, X-Ray Computed