Non Invasive Imaging

A1063JACC April 1, 2014

Volume 63, Issue 12

long TerM prognosTic valUe of coronary cT angiography in sUspecTed coronary arTery disease, a 62 MonThs Median follow-Up sTUdy

Poster ContributionsHall CSaturday, March 29, 2014, 3:45 p.m.-4:30 p.m.

Session Title: Coronary CT Angiography and OutcomesAbstract Category: 18. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT AngiographyPresentation Number: 1137-23

Authors: Mouaz H. Al-Mallah, Waqas Qureshi, Milan Pantelic, Khaled Nour, Henry Ford Hospital, Detroit, MI, USA, King AbdulAziz Cardiac Center, Riyadh, Saudi Arabia

Background: Coronary Computed Tomography Angiography (CCTA) has emerged as a new tool for non-invasive detection of coronary artery disease (CAD) with excellent short and intermediate term prognosis. The aim of this analysis is to determine the long term prognostic value of CCTA in predicting major adverse cardiac events (MACE).

Methods: The study population consisted of 454 consecutive patients who underwent CCTA (64-multidetector row scanner) at a single tertiary care center. Patients were followed up for a median follow-up duration of 62 months to determine the rate of MACE (all-cause mortality, myocardial infarction, late revascularization more than 90 days post CCTA).

results: A total of 194 (42%), 197 (44%) and 63 (14%) had normal, non-obstructive and obstructive CAD on CCTA respectively. At a median follow-up duration of 62 months, 38 (8.4%) patients experienced MACE. The annual event rate for patients with normal coronaries, non-obstructive CAD and obstructive CAD were 0.9%, 1.7% and 3.7% respectively (p=0.002). In multivariable Cox proportional hazard models, the presence of obstructive coronary disease (HR 3.0, 95% CI 1.1 - 7.7, p=0.026) as well as measures of disease severity (Segment Stenosis Score HR 1.08 (1.03 - 1.13), p=0.002) were independently associated with worse outcomes obstructive CAD.

conclusions: Our analysis extends the warranty period of a normal CCTA up to five years. Obstructive CAD on CCTA is associated with worse long term prognosis.