627Midterm prognosis value of multidetector coronary computed tomographic angiography in patients with suspected coronary artery disease


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Abstract

Purpose: Although studies have demonstraded a high diagnostic accuracy of multislice computed tomography coronary angiography (MCTCA) for detection of coronary artery disease (CAD), data regarding the prognosisvalue of MCTCA are limited. The purpose of this work is to assess the rate of adverse outcomes by MCTCA.Methods: between january 2008 and june2010, 404 consecutive patients with suspected CAD undergoing 64-slice MCTCA wereobserved for the ocurrence of cardiac events (death, myocardion infarction, unstable angina, hospitalization and revascularization). The observed rate of all cardiac events was compared with the event rate predicted by known risk factors. The presence of CAD by MCTCA was defined as presence of anyplaque observed in any coronary artery.Results: 71,8% were men, with a median age of 58,4± 12,4 years old. During a median follow-up of 15 months, there were 44 events. In multivariable Cox proporcional-hazard analysis, NYHA functional class, smoking, diabetes and CAD on MCTCA remained predictors of adverse outcome, being MCTCA the best predictor after adjustment for other well-established parameters predictors of outcome in CAD (table).Conclusions: In patients with suspected CAD, MCTCA has a significant midterm prognostic impact on the prediction of cardiac events. The presence of CAD by MCTCA identifies a patient population with an event risk higher than predicted by conventional risk factors.

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