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Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering


Buechel, R R; Pazhenkottil, A P; Herzog, B A; Brueckner, M; Nkoulou, R; Ghadri, J R; Küest, S M; Wyss, C A; Husmann, L; Kaufmann, P A (2011). Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering. Heart, 97(17):1385-1390.

Abstract

Objective To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective ECG triggering in a patient population with known or suspected coronary artery disease (CAD).

Design Longitudinal follow-up study.

Setting Tertiary referral cardiac imaging centre.

Patients 434 consecutive patients who were referred for evaluation of CAD by CCTA.

Methods The presence, distribution and severity of coronary lesions (non-obstructive <50% vs obstructive ≥50% luminal narrowing) were recorded by low-dose prospective ECG-triggered CCTA for each patient. The prognostic value of low-dose CCTA to predict major adverse cardiac events, defined as cardiac death, non-fatal myocardial infarction, or the need for revascularisation, was assessed using multivariate Cox regression analysis. Each person was followed up by telephone interviews and/or on the basis of clinical records. Thirty-eight early revascularised patients were excluded from outcome analysis.

Results Completely normal coronary arteries were documented in 171 patients (47%), while exclusively non-obstructive lesions were found in 66 (18%), and obstructive coronary lesions were diagnosed in 130 patients (35%). A mean follow-up of 47±16 weeks was obtained. The first-year event rate was 0% in patients with normal coronary arteries on CCTA but increased to 3% and 26% in patients with non-obstructive and obstructive coronary artery lesions, respectively. In multivariate Cox regression analysis, a significant predictor of events was the presence of obstructive or any coronary lesions. Mean effective radiation dose was 1.8±0.6 mSv.

Conclusions These data document an excellent prognostic performance of low-dose CCTA.

Objective To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective ECG triggering in a patient population with known or suspected coronary artery disease (CAD).

Design Longitudinal follow-up study.

Setting Tertiary referral cardiac imaging centre.

Patients 434 consecutive patients who were referred for evaluation of CAD by CCTA.

Methods The presence, distribution and severity of coronary lesions (non-obstructive <50% vs obstructive ≥50% luminal narrowing) were recorded by low-dose prospective ECG-triggered CCTA for each patient. The prognostic value of low-dose CCTA to predict major adverse cardiac events, defined as cardiac death, non-fatal myocardial infarction, or the need for revascularisation, was assessed using multivariate Cox regression analysis. Each person was followed up by telephone interviews and/or on the basis of clinical records. Thirty-eight early revascularised patients were excluded from outcome analysis.

Results Completely normal coronary arteries were documented in 171 patients (47%), while exclusively non-obstructive lesions were found in 66 (18%), and obstructive coronary lesions were diagnosed in 130 patients (35%). A mean follow-up of 47±16 weeks was obtained. The first-year event rate was 0% in patients with normal coronary arteries on CCTA but increased to 3% and 26% in patients with non-obstructive and obstructive coronary artery lesions, respectively. In multivariate Cox regression analysis, a significant predictor of events was the presence of obstructive or any coronary lesions. Mean effective radiation dose was 1.8±0.6 mSv.

Conclusions These data document an excellent prognostic performance of low-dose CCTA.

Citations

8 citations in Web of Science®
9 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:September 2011
Deposited On:17 Nov 2011 10:26
Last Modified:05 Apr 2016 15:06
Publisher:BMJ Publishing Group
ISSN:1355-6037
Publisher DOI:10.1136/hrt.2010.217638
PubMed ID:21487129
Permanent URL: http://doi.org/10.5167/uzh-51131

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