Abstract 4219: Prognostic Utility of Coronary Angiography using 64-slice Computed Tomography in Patients with Suspected but No Documented Coronary Artery Disease
Although multislice computed tomography (MSCT) detects obstructive coronary artery disease (CAD) with high diagnostic accuracy, there is paucity of long-term prognostic data. We sought to assess the incremental prognostic value of 64-slice CT in patients with suspected, but no documented CAD. Coronary MSCT was performed on 227 individuals (61% men, mean age 54 ± 12 years, 63 % with intermediate pre-test probability) without documented CAD, referred for coronary evaluation. CAD by MSCT was categorized as follows: none or mild CAD (< 50 %, n = 172), ≥ 50% in 1-vessel (n = 23), 2-vessels [or in the proximal left anterior descending (LAD), n = 12] and 3-vessels (or in 2-vessels including the proximal LAD or left main, n = 20). Baseline risk factors were recorded. Length of follow-up and major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI) and coronary revascularization were recorded. Over a mean follow-up of 2.3 ± 0.8 years, there were 18 MACE (including 1 cardiac death and 3 MI). Results of univariate and multivariate Cox proportional analysis are shown in Table⇓. Figure⇓ shows survival free from MACE, based on the extent of CAD. In 172 patients, with none or mild CAD, incidence of MACE was 0.5 % per year. MSCT classified extent of CAD provides incremental prognostic information in patients with suspected, but no documented, CAD.