Document Detail


Prognostic value of 64-slice cardiac computed tomography severity of coronary artery disease, coronary atherosclerosis, and left ventricular ejection fraction.
MedLine Citation:
PMID:  20202518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to determine the prognostic and incremental value of coronary artery disease (CAD) severity, coronary atherosclerosis, and left ventricular ejection fraction (LVEF) measured with cardiac computed tomography angiography (CTA). BACKGROUND: CTA is an emerging tool used for the detection of obstructive CAD. However, there are limited data supporting the prognostic value of 64-slice CTA and its ability to predict all-cause mortality and major adverse cardiac events such as cardiac death and nonfatal myocardial infarction. METHODS: Consecutive patients (without history of revascularization, heart transplantation, and congenital heart disease) were prospectively enrolled. Each CTA was evaluated for CAD severity, total plaque score, and LVEF. Patients were followed, and all events were confirmed with death certificates or hospital or physician records and reviewed by a clinical events committee. RESULTS: Between February 2006 and February 2008, 2,076 consecutive patients were prospectively enrolled and followed for a mean of 16 +/- 8 months. At follow-up, a total of 31 (1.5%) patients had cardiac death or nonfatal myocardial infarction and 47 (2.3%) had all-cause mortality or nonfatal myocardial infarction. Multivariate analysis showed that CAD severity (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.89 to 4.83) was a predictor of major adverse cardiac events and that LVEF (HR: 1.47; 95% CI: 1.17 to 1.86) had incremental value over CAD severity. Total plaque score had incremental value over CAD severity and LVEF for all-cause mortality and nonfatal myocardial infarction (HR: 1.17; 95% CI: 1.06 to 1.29). CONCLUSIONS: Using CTA, CAD severity, LVEF, and total plaque score seems to have prognostic and incremental value over routine clinical predictors. Cardiac CTA seems to be a promising noninvasive modality with prognostic value.
Authors:
Benjamin J W Chow; George A Wells; Li Chen; Yeung Yam; Paul Galiwango; Arun Abraham; Tej Sheth; Carole Dennie; Rob S Beanlands; Terrence D Ruddy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  55     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1017-28     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. bchow@ottawaheart.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cause of Death
Coronary Angiography / methods*
Coronary Artery Disease / mortality,  physiopathology,  radiography*
Female
Follow-Up Studies
Humans
Image Processing, Computer-Assisted / methods*
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology,  radiography
Prognosis
Prospective Studies
Sensitivity and Specificity
Stroke Volume / physiology*
Survival Analysis
Tomography, Spiral Computed / methods*
Ventricular Dysfunction, Left / mortality,  physiopathology,  radiography*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 Mar 9;55(10):1029-31   [PMID:  20202519 ]

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