Prognostic value of computed tomography coronary angiography in patients with chest pain of suspected cardiac origin
Purpose: The authors sought to determine the prognostic value of computed tomography coronary angiography (CTCA) in patients with acute chest pain (ACP). Materials and methods: A total of 145 consecutive patients (75 men; 64±12 years) with ACP were referred from the Emergency Department for CTCA, which was performed with a standard protocol using a 64-slice scanner. Patients were stratified according to the Morise clinical score (low, intermediate, high) and to the CTCA findings [absence of coronary artery disease (CAD), nonobstructive CAD, obstructive CAD]. Patients were followed up for the occurrence of major events: cardiac death, nonfatal myocardial infarction, unstable angina and revascularisation. Results: One hundred and twenty-seven (87.6%) patients were without a history of CAD, and 18 (12.4%) patients had a history of CAD. Obstructive CAD (>50% luminal narrowing) was detected in 35 (24%) patients; nonobstructive CAD (≤50% luminal narrowing) in 62 (43%) and absence of CAD in 48 (33%) patients. During a mean follow-up of 20±3 months, 20 events occurred (four hard events). Sixteen events (three hard events) occurred in patients without a history of CAD, and four events (one hard event) occurred in patients with a history of CAD. In patients with absence of CAD as detected by CTCA, the rate of events was 0%. At multivariate analysis, hypercholesterolaemia and obstructive CAD were significant predictors of events (p<0.05). Conclusions: An excellent prognosis was observed in patients with ACP and normal CTCA. CTCA shows the potential for optimal stratification of patients with ACP.
|Keywords||Acute chest pain, Computed tomography coronary angiography, Prognosis, Prognostic value|
|Persistent URL||dx.doi.org/10.1007/s11547-011-0647-z, hdl.handle.net/1765/33340|
Maffei, E, Seitun, S, Martini, C, Aldrovandi, A, Cervellin, G, Tedeschi, C, … Cademartiri, F. (2011). Prognostic value of computed tomography coronary angiography in patients with chest pain of suspected cardiac origin. La Radiologia Medica, 116(5), 690–705. doi:10.1007/s11547-011-0647-z