Document Detail


Major adverse cardiac events and the severity of coronary atherosclerosis assessed by computed tomography coronary angiography in an outpatient population with suspected or known coronary artery disease.
MedLine Citation:
PMID:  21052023     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To investigate the predictive value of 64-slice computed tomography coronary angiography (CTCA) for major adverse cardiac events (MACEs) in patients with suspected or known coronary artery disease (CAD).
MATERIALS AND METHODS: Seven hundred and sixty-seven consecutive patients (496 men, age 62±11 y) with suspected or known heart disease referred to an outpatient clinic underwent 64-slice CTCA. The patients were followed for the occurrence of MACE (ie, cardiac death, nonfatal myocardial infarction, unstable angina).
RESULTS: Eleven thousand five hundred and sixty-four coronary segments were assessed. Of these, 178 (1.5%) were not assessable because of insufficient image quality. Overall, CTCA revealed the absence of CAD in 219 (28.5%) patients, nonobstructive CAD (coronary plaque ≤50%) in 282 (36.8%) patients, and obstructive CAD in 266 (34.7%) patients. A total of 21 major cardiac events (4 cardiac deaths, 12 myocardial infarctions, and 5 unstable angina) occurred during a mean follow-up of 20 months. One noncardiac death occurred. Seventeen events occurred in the group of patients with obstructive CAD, and 4 events occurred in the group with nonobstructive CAD. The event rate was 0% among patients with normal coronary arteries at CTCA. In multivariate analysis, the presence of obstructive CAD and diabetes were the only independent predictors of MACE.
CONCLUSIONS: Coronary plaque evaluation by CTCA provides an independent prognostic value for the prediction of MACE. Patients with normal CTCA findings have an excellent prognosis at follow-up.
Authors:
Annachiara Aldrovandi; Erica Maffei; Sara Seitun; Chiara Martini; Elena Berti; Roberto Grilli; Giancarlo Messalli; Annick C Weustink; Nico R Mollet; Koen Nieman; Diego Ardissino; Pim J de Feyter; Gabriel P Krestin; Filippo Cademartiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic imaging     Volume:  27     ISSN:  1536-0237     ISO Abbreviation:  J Thorac Imaging     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606160     Medline TA:  J Thorac Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  23-8     Citation Subset:  IM    
Affiliation:
*Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma ‡Healthcare and Social Agency, Regione Emilia Romagna, Bologna §SDN Foundation, Naples, Italy †Department of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
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