Author + information
- Received May 1, 2006
- Revision received July 24, 2006
- Accepted July 27, 2006
- Published online January 2, 2007.
- Gabija Pundziute, MD⁎,†,1,
- Joanne D. Schuijf, MSc⁎,‡,1,
- J. Wouter Jukema, MD, PhD⁎,‡,
- Eric Boersma, PhD§,
- Albert de Roos, MD, PhD∥,
- Ernst E. van der Wall, MD, PhD⁎,‡ and
- Jeroen J. Bax, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
Objectives This study sought to determine the prognostic value of multislice computed tomography (MSCT) coronary angiography in patients with known or suspected coronary artery disease (CAD).
Background It is expected that MSCT will be used increasingly as an alternative imaging modality in the diagnosis of patients with suspected CAD. Data on the prognostic value of MSCT, however, are currently not available.
Methods A total of 100 patients (73 men, age 59 ± 12 years) who were referred for further cardiac evaluation due to suspicion of significant CAD underwent additional MSCT coronary angiography to evaluate the presence and severity of CAD. Patients were followed up for the occurrence of: 1) cardiac death, 2) nonfatal myocardial infarction, 3) unstable angina requiring hospitalization, and 4) revascularization.
Results Coronary plaques were detected in 80 (80%) patients. During a mean follow-up of 16 months, 33 events occurred in 26 patients. In patients with normal coronary arteries on MSCT, the first-year event rate was 0% versus 30% in patients with any evidence of CAD on MSCT. The observed event rate was highest in the presence of obstructive lesions (63%) and when obstructive lesions were located in the left main (LM)/left anterior descending (LAD) coronary arteries (77%). Nonetheless, an elevated event rate was also observed in patients with nonobstructive CAD (8%). In multivariate analysis, significant predictors of events were the presence of CAD, obstructive CAD, obstructive CAD in LM/LAD, number of segments with plaques, number of segments with obstructive plaques, and number of segments with mixed plaques.
Conclusions Multislice computed tomography coronary angiography provides independent prognostic information over baseline clinical risk factors in patients with known and suspected CAD. An excellent prognosis was noted in patients with a normal MSCT.
↵1 Drs. Pundziute and Schuijf contributed equally to this article and are shared first authors.
Supported by the Training Fellowship of the European Society of Cardiology and the Huygens scholarship, the Hague, the Netherlands (Dr. Pundziute) and The Netherlands Heart Foundation, the Hague, the Netherlands, grant 2002B105 (Dr. Schuijf).
Frank Bengel, MD, served as the Guest Editor for this article.
- Received May 1, 2006.
- Revision received July 24, 2006.
- Accepted July 27, 2006.
- American College of Cardiology Foundation