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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-20260

Van Werkhoven, J; Gaemperli, O; Schuijf, J D; Jukema, J W; Kroft, L J; Leschka, S; Alkadhi, H; Valenta, I; Pundziute, G; De Roos, A; Van der Wall, E E; Kaufmann, P A; Bax, J J (2009). Multi-slice Computed Tomography Coronary Angiography for Risk Stratification in Patients with an Intermediate Pre-test Likelihood. Heart, 95(19):1607-1611.

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OBJECTIVES: The purpose of this study was to assess whether MSCTA may be useful for risk stratification of patients with suspected CAD at intermediate pre-test likelihood according to Diamond and Forrester. Design and PATIENTS: MSCTA images were evaluated for the presence of significant CAD in 316 included patients (60% male, average age 57+/-11 years) with suspected CAD and an intermediate pre-test likelihood according to Diamond and Forrester. Patients were followed in time for the occurrence of an event. MAIN OUTCOME MEASURES: A combined endpoint of all cause mortality, non-fatal infarction, and unstable angina requiring revascularization. RESULTS: Significant CAD was observed in 89 patients (28%), whereas normal MSCTA or non-significant CAD was observed in the remaining 227 (72%) patients. During follow-up (median 621 days (95%-confidence interval: 408-835) an event occurred in 13 patients (4.8%). The annualized event rate was 0.8% in patients with normal MSCT, 2.2% in patients with non-significant CAD and 6.5% in patients with significant CAD. Moreover, MSCTA remained a significant predictor (p<0.05) of events after multivariate correction. CONCLUSIONS: Our results suggest that in an intermediate pre-test likelihood population, MSCTA is highly effective in re-stratifying patients into either a low or high post-test risk group. These results further emphasize the usefulness of non-invasive imaging with MSCTA in this patient population.


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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Date:October 2009
Deposited On:18 Aug 2009 12:34
Last Modified:05 Apr 2016 13:19
Publisher:BMJ Publishing Group
Publisher DOI:10.1136/hrt.2009.167353
PubMed ID:19581272

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