Document Detail


Prognostic value of coronary computed tomographic angiography in comparison with calcium scoring and clinical risk scores.
MedLine Citation:
PMID:  20884832     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background- Several studies have demonstrated a high accuracy of coronary computed tomography angiography (CCTA) for detection of obstructive coronary artery disease (CAD), whereas some studies have also shown a good prediction of cardiac events. However, it remains to be proven whether CCTA is better predictive of events than conventional risk scores or calcium scoring. Therefore, we compared CCTA with calcium scoring and clinical risk scores for the ability to predict cardiac events. Methods and Results- Patients (n=2223) with suspected CAD undergoing CCTA were followed up for a median of 28 months. The end point was the occurrence of cardiac events (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, and coronary revascularization later than 90 days after CCTA). Patients with obstructive CAD had a significantly higher event rate (2.9% per year; 95% confidence interval, 2.1 to 4.0) than those without obstructive CAD, having an event rate 0.3% per year (95% confidence interval, 0.1 to 0.5; hazard ratio, 13.5; 95% confidence interval, 6.7 to 27.2; P<0.001). CCTA had significant incremental predictive value when compared with calcium scoring, both with scores assessing the degree of stenosis (P<0.001) and with scores assessing the number of diseased coronary segments (P=0.027). Conclusions- In patients with suspected CAD, CCTA not only detects coronary stenosis but also improves prediction of cardiac events over and above conventional risk scores and calcium scoring. This may result in a reclassification of cardiovascular risk in a substantial proportion of patients.
Authors:
Martin Hadamitzky; Roland Distler; Tanja Meyer; Franziska Hein; Adnan Kastrati; Stefan Martinoff; Albert Schömig; Jörg Hausleiter
Publication Detail:
Type:  Journal Article     Date:  2010-09-30
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  4     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  16-23     Citation Subset:  IM    
Affiliation:
Klinik für Herz und Kreislauferkrankungen, Institut für Radiologie und Nuklearmedizin, Deutsches Herzzentrum München, Hospital at the Technische Universität München, Munich, Germany.
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