Oliver Gaemperli MD, Abstract Co-Author: Nothing to Disclose

Ines Valenta, Presenter: Nothing to Disclose

Tiziano Schepis, Abstract Co-Author: Nothing to Disclose

Lars Husmann MD, Abstract Co-Author: Nothing to Disclose

Sebastian Leschka MD, Abstract Co-Author: Nothing to Disclose

Hans Scheffel, Abstract Co-Author: Nothing to Disclose

Hatem Alkadhi MD, Abstract Co-Author: Nothing to Disclose

Philipp A. Kaufmann MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Sixty-four-slice CT angiography (CTA) has an excellent diagnostic accuracy for the detection of coronary artery disease (CAD). Its prognostic value, however, is unestablished yet.

In 220 patients (mean age 63 ± 11 years, 77 (35%) female) with known or suspected CAD referred to our institution for further cardiac evaluation an additional 64-slice coronary CTA was performed. CTA images were analyzed using the CardIQ Xpress software with regard to the presence and number of coronary lesions. Patients were followed-up for the occurrence of the following clinical endpoints: overall and cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, and coronary revascularization.

During a mean follow-up of 14 ± 4 months 59 patients (27%) reached at least one of the predefined clinical endpoints. Patients with abnormal coronary arteries on CTA (i.e. presence of coronary plaques) had an annual cardiac event rate of 28% whereas in patients with normal coronary arteries no events occurred (annual event rate, 0%, P 50% luminal narrowing) on CTA were associated with a high annual event rate (49%) compared to patients without stenoses (2%, P < 0.001). On multivariate regression analysis (corrected for baseline cardiovascular risk factors) the presence of obstructive lesions was a significant predictor of an adverse cardiac outcome. The presence of ≥3 plaques or ≥1 obstructive lesions was the cut-off with the best accuracy to predict future cardiac events.

Sixty-four-slice CTA predicts cardiac events in patients with known or suspected CAD. Conversely, patients with normal coronary arteries on CTA have an excellent prognosis.

64-slice CT angiography has important prognostic value in stable patients with known or suspected coronary artery disease.

Gaemperli, O, Valenta, I, Schepis, T, Husmann, L, Leschka, S, Scheffel, H, Alkadhi, H, Kaufmann, P, et al, , et al, , Coronary 64-slice CT Angiography Predicts Outcome in Patients with Known or Suspected Coronary Artery Disease.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011839.html