title: Prognostic value of dual-source multidetector computed tomography coronary angiography in patients with stent implantation.
abstract: We aim to evaluate the prognostic value of dual-source 64-slice multidetector computed tomography (MDCT) in patients with coronary stents. The study included 173 patients [mean age 59.9 ± 10.1 years, 76.7 % male] with previous stent implantation who underwent MDCT for evaluation of CAD and stent patency. Coronary imaging was performed via dual-source MDCT scanner. Stented vessel segment was evaluated as patent without neointimal hyperplasia (NIH), nonobstructive NIH (<50 % luminal narrowing), or obstructive NIH (>50 % luminal narrowing). Patients were evaluated for major cardiovascular events (MACEs) to demonstrate association between stent patency and clinical outcome. MACEs that were originating from non-stented segments were excluded. A total of 213 coronary stents were evaluated in our study. During mean of 21.2 ± 13.6 months' follow-up, 25 patients experienced MACEs [1 (4.0 %) cardiac death, 5 (20.0 %) nonfatal MI, and 19 (76.0 %) unstable angina pectoris requiring hospitalization and target vessel revascularization] associated with stented segment of coronary arteries. One hundred of 105 patients (95.2 %) with a patent stent without NIH detected by MDCT had no cardiac event associated with stented segments during mean 2 years' follow-up period. These data indicate that patients with a patent stent without NIH as determined by MDCT have a good prognosis as opposed to an increased rate of events among patients with either nonobstructive or obstructive NIH as determined with MDCT, supporting MDCT as a reliable tool to evaluate patients after coronary stenting.
authors.affiliation: Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey, hamzasunman@gmail.com.
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Ayşegül Ülgen
authors.initials: AÜ
authors.lastname: Kunak
authors.forename: Muhammet
authors.initials: M
authors.lastname: Dural
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazırolan
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Ergün Barış
authors.initials: EB
authors.lastname: Kaya
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoğlu
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakçı
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006965:Hyperplasia; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D058426:Neointima; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency