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Prognostic value of CT coronary angiography: focus on obstructive vs. nonobstructive disease and on the presence of left main disease.
Radiol Med. 2011 Feb; 116(1):15-31.RM

Abstract

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.

Authors+Show Affiliations

Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng ita

PubMed ID

20927651

Citation

Maffei, E, et al. "Prognostic Value of CT Coronary Angiography: Focus On Obstructive Vs. Nonobstructive Disease and On the Presence of Left Main Disease." La Radiologia Medica, vol. 116, no. 1, 2011, pp. 15-31.
Maffei E, Seitun S, Martini C, et al. Prognostic value of CT coronary angiography: focus on obstructive vs. nonobstructive disease and on the presence of left main disease. Radiol Med. 2011;116(1):15-31.
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. (2011). Prognostic value of CT coronary angiography: focus on obstructive vs. nonobstructive disease and on the presence of left main disease. La Radiologia Medica, 116(1), 15-31. https://doi.org/10.1007/s11547-010-0592-2
Maffei E, et al. Prognostic Value of CT Coronary Angiography: Focus On Obstructive Vs. Nonobstructive Disease and On the Presence of Left Main Disease. Radiol Med. 2011;116(1):15-31. PubMed PMID: 20927651.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of CT coronary angiography: focus on obstructive vs. nonobstructive disease and on the presence of left main disease. AU - Maffei,E, AU - Seitun,S, AU - Martini,C, AU - Aldrovandi,A, AU - Arcadi,T, AU - Clemente,A, AU - Messalli,G, AU - Malagò,R, AU - Weustink,A, AU - Mollet,N, AU - Nieman,K, AU - Ardissino,D, AU - de Feyter,P, AU - Krestin,G, AU - Cademartiri,F, Y1 - 2010/10/06/ PY - 2009/12/31/received PY - 2010/02/22/accepted PY - 2010/10/8/entrez PY - 2010/10/12/pubmed PY - 2011/4/20/medline SP - 15 EP - 31 JF - La Radiologia medica JO - Radiol Med VL - 116 IS - 1 N2 - 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. SN - 1826-6983 UR - https://www.unboundmedicine.com/medline/citation/20927651/Prognostic_value_of_CT_coronary_angiography:_focus_on_obstructive_vs__nonobstructive_disease_and_on_the_presence_of_left_main_disease_ L2 - https://dx.doi.org/10.1007/s11547-010-0592-2 DB - PRIME DP - Unbound Medicine ER -