Ludovico La Grutta MD, Abstract Co-Author: Nothing to Disclose

Giovanni Gentile MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Lo Re MD, Presenter: Nothing to Disclose

Emanuele Grassedonio MD, Abstract Co-Author: Nothing to Disclose

Massimo Galia MD, Abstract Co-Author: Nothing to Disclose

Massimo Midiri MD, Abstract Co-Author: Nothing to Disclose

Computed Tomography Coronary Angiography (CTCA) is widely implemented in the clinical routine. The aim of the study was to assess the prognostic value of CTCA in patients with suspected coronary artery disease (CAD) at a single center during a five-year period.

349 patients (235 men, age 58.3±11.8 years) with suspected CAD (asymptomatic patients with a high cardiovascular risk profile n=136, symptomatic patients n=213) underwent 64-slice CTCA. Average follow-up time was 2.3±1.2 years. Patients were followed up for the occurrence of cardiac death (CD), non-fatal myocardial infarction (MI), hospitalization, and cardiac revascularization.

Patients presented the following prognostic outcome: in 125 patients (35.8%) with normal coronary arteries at CTCA the event rate was 0%; among the 126 patients (36.1%) with non obstructive CAD (≤50%), 30 received an individualized medical treatment, 2 had cardiac revascularization, and 1 had CD; among the 98 patients (28.1%) with obstructive CAD (>50%), 45 underwent revascularization, and 4 had CD. Asymptomatic patients had the following prognostic outcome: in 50 patients with normal coronary arteries at CTCA the event rate was 0%; among the 54 patients with non obstructive CAD, 10 received an individualized medical treatment and 1 had cardiac revascularization; 9 out of 32 patients with obstructive CAD had revascularization, and 2 had CD. Symptomatic patients had the following outcome: in 75 patients with normal coronary arteries at CTCA the event rate was 0%; among the 72 patients with non obstructive CAD, 4 had hospitalization, 20 received an individualized medical treatment, 2 had MI (1 fatal MI, 1 cardiac revascularization); 36 out of 66 patients with obstructive CAD underwent revascularization, and 2 had CD.

Asymptomatic and symptomatic patients with suspected CAD and negative CTCA have an excellent prognosis at long-term follow-up. Major cardiac events increase with CAD severity.

Patients with normal coronary arteries at CTCA may be reassured because of its high prognostic value, whereas CAD severity influences clinical decision-making and prognosis.

La Grutta, L, Gentile, G, Lo Re, G, Grassedonio, E, Galia, M, Midiri, M, Prognostic Value of Computed Tomography Coronary Angiography in Patients with Suspected Coronary Artery Disease: Five Years’ Experience at a Single Center.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043397.html