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Prognostic value of CT coronary angiography: focus on obstructive vs. nonobstructive disease and on the presence of left main disease.
Maffei, E; Seitun, S; Martini, C; Aldrovandi, A; Arcadi, T; Clemente, A; Messalli, G; Malagò, R; Weustink, A; Mollet, N; Nieman, K; Ardissino, D; de Feyter, P; Krestin, G; Cademartiri, F.
Afiliación
  • Maffei E; Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy.
Radiol Med ; 116(1): 15-31, 2011 Feb.
Article en En, It | MEDLINE | ID: mdl-20927651
PURPOSE: The authors investigated the prognostic value of computed tomography coronary angiography (CTCA) for major adverse cardiac events (MACE) in patients with suspected or known coronary artery disease (CAD), with particular focus on left main (LM) disease and obstructive vs. nonobstructive disease. MATERIALS AND METHODS: A total of 727 consecutive patients (485 men, age 62 ± 11 years) with suspected (514; 70.1%) or known (213; 29.9%) CAD underwent CTCA. Patients were followed up for the occurrence of MACE (i.e. cardiac death, nonfatal myocardial infarction, unstable angina, percutaneous/surgical revascularisation). RESULTS: A total of 117 MACE [five cardiac deaths, 11 acute myocardial infarctions (AMI), five unstable angina, 86 percutaneous coronary interventions, ten coronary artery bypass grafts] occurred during a mean follow-up of 20 months. Severity and extension of CAD was associated with a progressively worse prognosis. The event rate was 0% among patients with normal coronary arteries at CTCA. The presence of LM disease was not associated with a worse prognosis either in patients with no history of CAD or in those with a history of CAD. At multivariate analysis, presence of obstructive CAD and diabetes were the only independent predictors of MACE. CONCLUSIONS: Evaluation of atherosclerotic burden by CTCA provides an independent prognostic value for prediction of MACE. Patients with normal CTCA findings have an excellent prognosis at follow-up.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Tomografía Computarizada por Rayos X / Angiografía Coronaria Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / It Revista: Radiol Med Año: 2011 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Tomografía Computarizada por Rayos X / Angiografía Coronaria Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / It Revista: Radiol Med Año: 2011 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia