Prognostic value of computed tomography coronary angiography in patients with suspected coronary artery disease: a 24-month follow-up study |
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Authors: | Annachiara Aldrovandi Erica Maffei Alessandro Palumbo Sara Seitun Chiara Martini Valerio Brambilla Alessandra Zuccarelli Giuseppe Tarantini Annick C. Weustink Nico R. Mollet Livia Ruffini Girolamo Crisi Diego Ardissino Pim J. de Feyter Gabriel P. Krestin Filippo Cademartiri |
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Affiliation: | 1. Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy 2. Department of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands 3. Cardiovascular Prevention and Rehabilitation Unit, Don Gnocchi ONLUS, University of Parma, Parma, Italy 4. Department of Cardiology, Ospedale di Carrara, Carrara, Italy 5. Department of Cardiology, University of Padua, Padua, Italy 6. Department of Radiology, c/o Piastra Tecnica - Piano 0 - CT Section, Azienda Ospedaliero-Universitaria di Parma, via Gramsci, 14, 43100, Parma, Italy
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Abstract: | The aim of this study was to determine the predictive value of 64-slice computed tomography coronary angiography (CTCA) for major cardiac events in patients with suspected coronary artery disease (CAD). A total of 187 consecutive patients (119 men, age 62.5 ± 10.5 years) without known heart disease underwent single-source 64-slice CTCA (Somatom Sensation 64, Siemens) for clinical suspicion of CAD. Patients underwent follow-up for the occurrence of cardiac death, nonfatal myocardial infarction, unstable angina and cardiac revascularization. In total, 2,822 coronary segments were assessed. Forty-two segments (1.5%) were not assessable because of insufficient image quality. Overall, CTCA revealed absence of CAD in 65 (34.7%) patients, nonobstructive CAD (coronary plaque ≤50%) in 87 (46.5%) patients and obstructive CAD (>50%) in 35 (18.8%) patients. A total of 20 major cardiac events (3 myocardial infarctions, 16 cardiac revascularizations, 1 unstable angina) occurred during a mean follow-up of 24 months. One noncardiac death occurred. Seventeen events occurred in the group of patients with obstructive CAD and three events occurred in the group of nonobstructive CAD. The event rate was 0% among patients with normal coronary arteries at CTCA. CTCA has a 100% negative predictive value for major cardiac events at 24-month follow-up in patients with normal coronary arteries. |
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Keywords: | Computed tomography coronary angiography Prognosis Suspected coronary artery disease Prognostic value Midterm |
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