Abstract 14943: Prognostic Value of Multidetector Coronary Computed Tomographic Angiography in Patients With Known or Suspected Coronary Artery Disease
Background: In patients presenting with suspected or known coronary artery disease (CAD), assessment of prognosis is essential in selecting appropriate patient management. Noninvasive evaluation of symptomatic patients has primarily relied on stress nuclear myocardial perfusion imaging and echocardiography. Recently, multidetector computed tomography (MDCT) has been used for risk stratification in patients with known or suspected CAD. The purpose of this study was to determine the association of cardiac events with severity and extent of CAD on MDCT.
Methods: We studied 2,080 patients (931 males, 61.4±12.2 years) with known or suspected CAD undergoing 64-slice MDCT. The severity and extent of CAD, plaque of coronary arteries were analyzed. Patients were followed up for the occurrence of: 1) cardiac death, 2) nonfatal myocardial infarction 3) unstable angina requiring hospitalization, and 4) revascularization. The patients with experiencing early cardiac events within 30 day after MDCT were excluded from the analysis.
Results: The 1,107 patients (53.2%) had CAD. During mean follow-up 12.6±11.6 months, 76 patients (3.7%) had experienced cardiac events. In multivariate analysis after adjustment of traditional risk factors, significant predictor of cardiac event was obstructive CAD (HR 3.59, p=0.001) and numbers of segment with coronary plaques (HR 1.15, p<0.05). The patients with more than 3 numbers of segment with coronary plaques had more higher risk for cardiac event (9.8% vs 2.9% in one or two segments of coronary plaques vs. 0% in no coronary plaques). Especially, in nonobstructive CAD, the number of segments with coronary plaques was independent predictor of cardiac events
Conclusions: In our study, the presence of obstructive CAD and numbers of segment with coronary plaques were significant predictor of adverse cardiac events. MDCT might predict cardiac events in known or suspected CAD.
- © 2010 by American Heart Association, Inc.