Eun Ju Chun, Presenter: Nothing to Disclose

Ji Hoon Park MD, Abstract Co-Author: Nothing to Disclose

Sang Il Choi MD, Abstract Co-Author: Nothing to Disclose

Kil Joong Kim, Abstract Co-Author: Nothing to Disclose

Min Su Lee, Abstract Co-Author: Nothing to Disclose

Dong Ju Choi, Abstract Co-Author: Nothing to Disclose

: To evaluate the prognostic value of coronary CT angiography (CCTA) for risk stratification in asymptomatic adults in comparison to conventional risk stratification and coronary artery calcium scoring (CACS).

A total 4,586 asymptomatic subjects (mean age 52.5 yrs, male 60.5%) who underwent both CACS and CCTA between January, 2006 and December, 2007 were assessed for cardiac event including cardiac death, nonfatal myocardial infarction, unstable angina, or revascularization. CT images were analyzed as the plaque type and density, stenosis and presence of positive remodeling. Conventional risk factors were stratified according to NECP guidelines.

During a median of 42 months of follow-up, the cardiac event was developed in 84 patients (1.9%) including cardiac death (n=4), acute MI ( n=3), unstable angina (n=20). All of them have any plaques (100%) and 76 patients have significant stenosis (90.5%). Positive remodeling and low density attenuated plaque was detected in 6 of 8 patients (75%) without significant stenosis. 32 (38.1%) subjects with cardiac event were classified into low (n=4) or intermediate (n=28) risk. Moreover, 35 (41.7%) subjects had CACS lower than 100 and only 21 (25%) had higher than 400. In multivariate analysis, significant predictors of cardiac event were age, DM, HDL-cholesterol, Triglyceride, significant stenosis and positive remodeling with low attenuated plaque.

CCTA provides independent prognostic information over conventional risk stratification and CACS in asymptomatic individuals.

From this study, normal CCTA findings showed excellent clinical outcome. Additionally, CCTA would offer incremental prognostic value for risk prediction over conventional risk stratification and CACS.

Chun, E, Park, J, Choi, S, Kim, K, Lee, M, Choi, D, Prognostic Value of Coronary CT Angiography for Risk Stratification in Asymptomatic Individuals: ESCORT (Evaluation of Subclinical Coronary Atherosclerosis for Risk Stratification Using Coronary CT Angiography) Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012292.html