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Adding Coronary Computed Tomography Angiography to Invasive Coronary Angiography Improves Prediction of Cardiac Events.
MedLine Citation:
PMID:  25298167     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:The additive value of plaque characteristics determined by computed tomography angiography (CTA) in patients undergoing invasive coronary angiography (ICA) has not been established.Methods and Results:We studied 676 patients undergoing ICA and CTA within 3 months. The luminal diameter narrowing based on ICA and the presence of high risk plaque (HRP) based on CTA were assessed in all coronary artery segments except for those after or before scheduled treatment. We followed their cardiac events including cardiac death, acute coronary syndrome (ACS), and revascularization for de novo lesions ≥3 months after ICA. The incidence of coronary events was higher in the segments including >25% luminal narrowing than in those without (2.94% vs. 0.31%, P<0.0001), and higher in the segments containing HRP than in those without (12.6 vs. 0.46%, P<0.0001). Greater than 25% residual luminal narrowing and the presence of HRP were identified as independent predictors of cardiac events after risk adjustment for age, gender, and history of ACS (hazard ratio [HR], 3.22; 95% confidence interval [CI]: 1.29-10.76; P=0.0092, HR, 2.64; 95% CI: 1.59-4.35; P=0.0002, respectively). Adding the presence of HRP to a model including age, gender, ACS history, and >25% residual stenosis improved the prediction of cardiac events.Conclusions:Assessment of coronary plaque characteristics on CTA improves the prediction of cardiac events in patients undergoing ICA.
Authors:
Hideki Kawai; Sadako Motoyama; Masayoshi Sarai; Hajime Ito; Hiroshi Takahashi; Hiroto Harigaya; Shino Kan; Junichi Ishii; Hirofumi Anno; Toyoaki Murohara; Yukio Ozaki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-09
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-9     Completed Date:  -     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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