P496Prognostic value of noninvasive coronary angiography in the study of chest pain

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Introduction: The analysis of coronary anatomy by multislice computed tomography (CT), has established itself as a reliable test in those patients who were studied for chest pain by avoiding potential complications of invasive coronary angiography.Objective: To analyze the appearance of long-term cardiac events in patients with a positive CT scan for coronary artery disease compared with those in which the test was negative.Material and methods: Retrospective study of a cohort of 292 patients undergoing CT for chest pain, between 2008 and 2010, with follow-up period of 18 months. The sample was dichotomized into positive study (obstructive coronary plaques - ≥50% luminal narrowing) and a negative result, comparing the occurrence of coronary events defined as death, unstable angina (UA) or non-fatal myocardial infarction.Results: The gender distribution was 50% with an average age of 61 ± 11 years. A total of 217 cases (74%) were considered negative and 75 (26%) reported as positive. It detected a total of 8 events: 1 death, 2 non-fatal myocardial infarction and 5 episodes of unstable angina. We compared the occurrence of cardiac events in both groups and the negative predictive value of noninvasive coronary angiography for coronary artery disease was 99%. This association reached statistical significance (p <0.02). Although the event rate in patients without obstructive coronary lesions is low, it is important to know that these results also included patients who all ready suffered from previous coronary artery disease or where treated with revascularization.Conclusions: The noninvasive coronary angiography emerges as a viable alternative to invasive coronary angiography, based on patients with no obstructive lesions at the time of the procedure showing a low rate of events in the long term.

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