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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-20264

van Werkhoven, J M; Schuijf, J D; Gaemperli, O; Jukema, J W; Kroft, L J; Boersma, E; Pazhenkottil, A; Valenta, I; Pundziute, G; de Roos, A; van der Wall, E E; Kaufmann, P A; Bax, J J (2009). Incremental prognostic value of multi-slice computed tomography coronary angiography over coronary artery calcium scoring in patients with suspected coronary artery disease. European Heart Journal, 30(21):2622-2629.

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Aims The purpose of this study was to assess the relationship between calcium scoring (CS) and multi-slice computed tomography coronary angiography (MSCTA) and to determine if MSCTA has an incremental prognostic value to CS. Methods and results In 432 patients (59% male, age 58 +/- 11 years) referred for cardiac evaluation owing to suspected coronary artery disease (CAD), CS and 64-slice MSCTA were performed. The following events were combined in a composite endpoint: all-cause mortality, non-fatal infarction, and unstable angina requiring revascularization. CS was 0 in 147 (34%) patients, CS 1-99 was present in 122 (28%), CS 100-399 in 75 (17%), CS 400-999 in 56 (13%), and CS >/= 1000 in 32 (7%). MSCTA was normal in 133 (31%) patients, MSCTA 30-50% stenosis was observed in 190 (44%), and MSCTA >/=50% stenosis in 109 (25%). During follow-up [median 670 days (25th-75th percentile: 418-895)], an event occurred in 21 patients (4.9%). After multivariate correction for CS, MSCTA >/= 50% stenosis, the number of diseased segments, obstructive segments, and non-calcified plaques were independent predictors with an incremental prognostic value to CS. Conclusion MSCTA provides additional information to CS regarding stenosis severity and plaque composition. This additional information was shown to translate into incremental prognostic value over CS.


95 citations in Web of Science®
111 citations in Scopus®
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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
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Date:29 June 2009
Deposited On:18 Aug 2009 12:48
Last Modified:05 Apr 2016 13:19
Publisher:Oxford University Press
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:10.1093/eurheartj/ehp272
PubMed ID:19567382

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