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Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease

Gaemperli, Oliver ; Valenta, Ines ; Schepis, Tiziano ; Husmann, Lars ; Scheffel, Hans ; Desbiolles, Lotus ; Leschka, Sebastian ; Alkadhi, Hatem ; Kaufmann, Philipp

In: European Radiology, 2008, vol. 18, no. 6, p. 1162-1173

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    Title
    • Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease
    Author
    • Gaemperli, Oliver. Cardiovascular Center, University Hospital Zurich NUK C 32, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Valenta, Ines. Cardiovascular Center, University Hospital Zurich NUK C 32, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Schepis, Tiziano. Cardiovascular Center, University Hospital Zurich NUK C 32, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Husmann, Lars. Institute of Diagnostic Radiology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Scheffel, Hans. Institute of Diagnostic Radiology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Desbiolles, Lotus. Institute of Diagnostic Radiology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Leschka, Sebastian. Institute of Diagnostic Radiology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Alkadhi, Hatem. Institute of Diagnostic Radiology, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland
    • Kaufmann, Philipp. Cardiovascular Center, University Hospital Zurich NUK C 32, Ramistrasse 100, CH-8091, Zurich, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:315732
    Summary
    The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 ± 11years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: death, nonfatal myocardial infarction, unstable angina, and coronary revascularization. During a mean follow-up of 14 ± 4months, 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e., presence of coronary plaques) had a 1st-year event rate of 34%, whereas in patients with normal coronary arteries no events occurred (event rate, 0%, p < 0.001). Similarly, obstructive lesions (≥50% luminal narrowing) on CTA were associated with a high first-year event rate (59%) compared to patients without stenoses (3%, p < 0.001). The presence of obstructive lesions was a significant independent predictor of an adverse cardiac outcome. Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent mid-term prognosis