Abstract 12507: Long-Term Follow-up of 64-Slice Computed Tomography in Patients with Chest Pain at Intermediate Risk of Coronary Artery Disease
Background: Preliminary prognostic studies on coronary multislice computed tomography (CT) are available. No long-term follow-up studies in a homogeneous patients group who underwent 64-slice CT for chest pain have been published to date.
Objectives: The aim of this study was to assess the long-term incremental value of 64-slice CT in patients at intermediate risk of coronary artery disease with chest pain and no previous history of cardiac events. An analysis based on plaque texture was performed.
Methods: A total of 222 patients (136 men [61%], age 59±11 years) with chest pain at intermediate risk and no previous history of cardiac events underwent 64-slice CT. Coronary lesions were considered obstructive or not based on a threshold of 50% luminal narrowing. Plaques were classified as calcified, non-calcified and mixed based on type. End-point during follow-up was major adverse cardiac events (non-fatal myocardial infarction, unstable angina requiring hospitalization, myocardial revascularization).
Results: Coronary plaques were detected in 162 (73%) patients. Coronary artery stenosis was significant in 62 patients. Normal arteries were found in 59 patients (27%). During a mean follow-up of 4.8±0.8 years 30 cardiac events occurred. The annualized event rate was 0% in patients with normal coronary arteries, 1.2% in patients with non-significant obstructions and 4.2% in patients with significant obstructions (p<0.01). Significant predictors of cardiac events were the presence of significant stenosis, proximal stenosis and multivessel disease. Additionally, non-calcified and mixed plaques were carrying the worse prognosis (p<0.05) [figure 1].
Conclusions: 64-slice CT provides long-term incremental value in patients at intermediate risk of coronary artery disease.
- © 2010 by American Heart Association, Inc.