Abstract 5748: The Prognostic Value of Multi-Slice Computed Tomography Coronary Angiography in Patients with Suspected CAD and an Intermediate Pre-Test Likelihood
Objectives: Non-invasive coronary angiogrpahy with multi-slice computed tomography (CTA) has a high diagnostic accuracy. It has been suggested that the technique may be particularly useful in patients with an intermediate pre-test likelihood. However, its prognostic value in this population remains to be determined. The purpose of this study was to assess whether CTA may be useful for risk stratification of patients with suspected coronary artery disease (CAD) at intermediate pre-test likelihood.
Methods: CTA was performed in patients with suspected CAD and an intermediate pre-test likelihood. Images were evaluated for the presence of significant (≥50%) stenosis. The following events were recorded: All cause mortality, non-fatal infarction, and unstable angina requiring hospitalization.
Results: In 336 included patients (60% male, average age 58±11 years) an abnormal CTA with significant CAD was observed in 95 patients (28%), whereas a normal scan with no or non-significant CAD was observed in the remaining 241 (72%) patients. During follow-up (average 560± 333 days) an event occurred in 12 patients (4%). An absolute event rate of 1.7% was observed in patients with normal CTA versus an absolute event rate of 8.4% in patients with abnormal CTA.(Figure 1⇓) CTA remained a significant predictor (p<0.05) of events after correction for age, gender, and baseline risk factors in a multivariate model.
Conclusion: Our results suggest that in patients with suspected CAD and an intermediate pre-test likelihood, CTA can effectively distinguish between patients at low or at high risk for future events.