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Prognostic value of coronary CT angiography on long-term follow-up of 6.9 years

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Abstract

Long term follow-up of coronary CT angiography (CCTA) is scarce. The aim of the present study was to assess the prognostic value of CCTA over a follow-up period of more than 6 years. 218 Patients were included undergoing 64-slice CCTA. Images were analysed with regard to the presence of nonobstructive (<50 %) or obstructive (50 % stenosis) coronary artery disease (CAD). Major adverse cardiovascular events (MACE) were defined as death, nonfatal myocardial infarction or urgent coronary revascularization. CCTA revealed normal coronaries in 49, nonobstructive lesions in 94, and obstructive CAD in 75 patients. During a median follow-up period of 6.9 years, MACE occurred in 45 patients (21 %). Annual MACE rates were 0.3, 2.7, and 6.0 % (p = 0.001), for patients with normal CCTA, nonobstructive, and obstructive CAD, respectively. Multivariate Cox regression analysis identified the number of segments with plaques [hazard ratio (HR) 1.18, p = 0.002] as well as the presence of obstructive lesions (HR 2.28, p = 0.036) as independent predictors of MACE. The present study extends the predictive value of CCTA over more than 6 years. Patients with normal coronary arteries of CCTA continue to have an excellent cardiac prognosis, while outcome is progressively worse in patients with nonobstructive and obstructive CAD.

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References

  1. Abdulla J, Asferg C, Kofoed KF (2011) Prognostic value of absence or presence of coronary artery disease determined by 64-slice computed tomography coronary angiography a systematic review and meta-analysis. Int J Cardiovasc Imaging 27:413–420

    Article  PubMed  Google Scholar 

  2. Gaemperli O, Valenta I, Schepis T, Husmann L, Scheffel H, Desbiolles L et al (2008) Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease. Eur Radiol 18:1162–1173

    Article  PubMed  Google Scholar 

  3. Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ et al (2007) Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 50:1161–1170

    Article  PubMed  Google Scholar 

  4. van Werkhoven JM, Gaemperli O, Schuijf JD, Jukema JW, Kroft LJ, Leschka S et al (2009) Multislice computed tomography coronary angiography for risk stratification in patients with an intermediate pretest likelihood. Heart 95:1607–1611

    Article  PubMed  Google Scholar 

  5. Motoyama S, Sarai M, Harigaya H, Anno H, Inoue K, Hara T et al (2009) Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol 54:49–57

    Article  PubMed  Google Scholar 

  6. Min JK, Dunning A, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ et al (2011) Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol 58:849–860

    Article  PubMed  Google Scholar 

  7. Andreini D, Pontone G, Mushtaq S, Bartorelli AL, Bertella E, Antonioli L et al (2012) A long-term prognostic value of coronary CT angiography in suspected coronary artery disease. JACC Cardiovasc Imaging 5:690–701

    Article  PubMed  Google Scholar 

  8. Sozzi FB, Civaia F, Rossi P, Robillon JF, Rusek S, Berthier F et al (2011) Long-term follow-up of patients with first-time chest pain having 64-slice computed tomography. Am J Cardiol 107:516–521

    Article  PubMed  Google Scholar 

  9. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40

    Article  CAS  PubMed  Google Scholar 

  10. Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S et al (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 46:147–154

    Article  PubMed  Google Scholar 

  11. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832

    Article  CAS  PubMed  Google Scholar 

  12. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD (2012) Third universal definition of myocardial infarction. Eur Heart J 33:2551–2567

    Article  PubMed  Google Scholar 

  13. Fluss R, Faraggi D, Reiser B (2005) Estimation of the Youden index and its associated cutoff point. Biom J 47:458–472

    Article  PubMed  Google Scholar 

  14. Ostrom MP, Gopal A, Ahmadi N, Nasir K, Yang E, Kakadiaris I et al (2008) Mortality incidence and the severity of coronary atherosclerosis assessed by computed tomography angiography. J Am Coll Cardiol 52:1335–1343

    Article  PubMed  Google Scholar 

  15. Hadamitzky M, Taubert S, Deseive S, Byrne RA, Martinoff S, Schomig A et al (2013) Prognostic value of coronary computed tomography angiography during 5 years of follow-up in patients with suspected coronary artery disease. Eur Heart J 34:3277–3285

    Article  PubMed  Google Scholar 

  16. Chang SM, Nabi F, Xu J, Peterson LE, Achari A, Pratt CM et al (2009) The coronary artery calcium score and stress myocardial perfusion imaging provide independent and complementary prediction of cardiac risk. J Am Coll Cardiol 54:1872–1882

    Article  PubMed  Google Scholar 

  17. Abbara S, Arbab-Zadeh A, Callister TQ, Desai MY, Mamuya W, Thomson L et al (2009) SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 3:190–204

    Article  PubMed  Google Scholar 

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Acknowledgments

The study was supported by Grants from the Swiss National Science Foundation to PAK. Furthermore, we thank Ennio Mueller and Gentian Cermjani for their excellent technical support.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, NUK C 42, 8091, Zurich, Switzerland

    Svetlana Dougoud, Tobias A. Fuchs, Julia Stehli, Olivier F. Clerc, Ronny R. Buechel, Bernhard A. Herzog, Philipp A. Kaufmann & Oliver Gaemperli

  2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland

    Sebastian Leschka & Hatem Alkadhi

  3. Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland

    Philipp A. Kaufmann

  4. Institute of Radiology, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Sebastian Leschka

Authors
  1. Svetlana Dougoud
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  2. Tobias A. Fuchs
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  3. Julia Stehli
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  4. Olivier F. Clerc
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  5. Ronny R. Buechel
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  6. Bernhard A. Herzog
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  7. Sebastian Leschka
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  8. Hatem Alkadhi
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  9. Philipp A. Kaufmann
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  10. Oliver Gaemperli
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Corresponding author

Correspondence to Oliver Gaemperli.

Additional information

Svetlana Dougoud and Tobias A. Fuchs have contributed equally to this work and share first coauthorship.

Philipp A. Kaufmann and Oliver Gaemperli have contributed equally to this work and share last coauthorship.

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Dougoud, S., Fuchs, T.A., Stehli, J. et al. Prognostic value of coronary CT angiography on long-term follow-up of 6.9 years. Int J Cardiovasc Imaging 30, 969–976 (2014). https://doi.org/10.1007/s10554-014-0420-1

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  • DOI: https://doi.org/10.1007/s10554-014-0420-1

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