Prognostic outcome of routine clinical noninvasive multidetector-row computed tomography coronary angiography in patients with suspected coronary artery disease: a 2-year follow-up study

• Published in: Radiologia medica Vol. 116; no. 4; pp. 521 - 531
• Main Authors: La Grutta, L., Runza, G., Gentile, G., Russo, E., Lo Re, G., Galia, M., Bartolotta, T. V., Alaimo, V., Malagò, R., Cademartiri, F., Cardinale, A. E., Midiri, M.
• Format: Journal Article
• Language: English; Italian
• Published: Milan Springer Milan 01.06.2011
• Subjects: Cardiac Radiology; Cardioradiologia; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Diagnostic Radiology; Female; Humans; Image Processing, Computer-Assisted; Imaging; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Predictive Value of Tests; Prognosis; Radiology; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasound; Prognostic value; Multidetector row computed tomography; Valore prognostico; Angiografia coronarica; Coronary angiography; Tomografia computerizzata multistrato; Coronary artery disease; Malattia aterosclerotica coronarica
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-011-0655-z

Purpose The aim of the study was to assess the prognostic value of multidetector-row CT coronary angiography (MDCT-CA) in patients with suspected coronary artery disease (CAD) in a routine clinical context. Materials and methods A total of 125 patients (82 men, age 57.4±10.3 years) with suspected CAD underwent MDCT-CA. All patients were assessed for cardiovascular risk factors, symptoms and coronary calcium score. A 2-year follow-up study for the occurrence of major adverse cardiac events was performed. Results According to the Morise pretest score, 76 patients (60.8%) were at intermediate risk. Patients with suspected CAD presented the following prognostic outcome ( p <0.0001): in 41 patients with normal coronary arteries at MDCT-CA, the event rate was 0%; five of 49 patients with nonobstructive CAD had major cardiac events; two of 35 patients with obstructive CAD suffered cardiac death and 19 underwent revascularisation. At multivariate analysis, the presence of obstructive CAD is the only significant independent prognostic variable (hazard ratio, 10.1393; 95% confidence interval 3.2189–31.9379; p <0.0001). Conclusions Routine clinical MDCT-CA provides an excellent prognostic value at 2-year follow-up in patients with normal coronary arteries. The cardiac event rate increases with CAD severity.