Author + information
- Pradnya Velankar,
- Belqis El Ferjani,
- Sayf Khaleel Bala,
- Kongkiat Chaikriangkrai,
- Zahoor Khan,
- Venkateshwar Polsani,
- Faisal Nabi and
- Su Min Chang
Coronary Computed Tomographic Angiography (CCTA) with prospective ECG gating (PG) reduces radiation exposure as compared to retrospective ECG gating (RG), yet its prognostic value is less validated. Our aim was to compare prognostic performance of 64 slice CCTA with PG vs RG in patients (pts) with suspected coronary disease (CAD).
A cohort of 620 pts with no known CAD undergoing CCTA was followed up to 3 years (minimum 1 year, median 2.2 years). PG was used in 29% (177 pts) and RG in 71% (443 pts of which 201 had dose modulation). Adverse cardiac events (cardiac death, non fatal MI, late revascularization or ACS with coronary stenosis > 50 % on catheterization) occurred in 22 pts (3.6%).
Mean age was 59 years, with 56% male, 11% diabetics, and 23% on statins. Normal CCTA was seen in 260 pts (42%), non obstructive / <50% lesion in 289 pts (46%) and 71 pts (12%) had obstructive or ≥50 % lesion. PG was used in 27% of pts with events as compared to 29% of those without (p=0.9). Annual event rates stratified by CCTA did not differ between PG and RG groups (Figure). Multivariable analysis (adjusted for age, gender and diabetes) showed that presence of CAD on CCTA was a strong predictor of outcome (vs normal CCTA: odds ratio of 3.5 for non obstructive lesions, p=0.01 and 22.5 for obstructive lesions, p=0.001). Mean effective radiation dose was 4 ± 0.5 for PG vs 13.2± 3 mSV for RG (p <0.001).
CCTA with PG has comparable prognostic value as CCTA with RG in a low to intermediate risk population with suspected CAD.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: CT/Multimodality III
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1181-347
- 2013 American College of Cardiology Foundation