Coronary computed tomography angiography can predict risk of cardiac events
17 april 2009-- Coronary computed tomography angiography (CCTA) is effective in predicting cardiac events in patients with suspected coronary artery disease, according to a study in the April issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
Martin Hadamitzky, M.D., and colleagues from Technische Universitat Munchen in Munich, Germany, examined the ability of 64-slice CCTA to detect obstructive coronary artery disease (defined as 50 percent or greater diameter stenosis in any coronary artery) in 1,150 patients with suspected coronary artery disease. The cardiac event rate was compared with that predicted by the Framingham risk score.
As a result of CCTA, the researchers determined that 348 patients had obstructive coronary artery disease. During a median 18-month follow-up, the rate of severe cardiac events (cardiac death, myocardial infarction, or unstable angina requiring hospitalization) was 0.6 percent and the rate of all cardiac events was 1.8 percent. Patients determined to have coronary artery disease were at much higher risk of both severe events (odds ratio, 17.3) and all events (odds ratio, 16.1). Patients without coronary artery disease had a significantly lower rate of all events than was predicted by the Framingham risk score, the authors note.
"In patients with suspected coronary artery disease, CCTA has a significant prognostic impact on the prediction of cardiac events for the subsequent 18 months," Hadamitzky and colleagues conclude. "The exclusion of obstructive coronary artery disease by CCTA identifies a patient population with an event risk lower than predicted by conventional risk factors."