Prognostic Value of CCTA Explored for Suspected CAD
Found helpful in assessing heart attack risk in suspected CAD without modifiable risk factors
WEDNESDAY, Feb. 20 (HealthDay News) -- For individuals with suspected coronary artery disease (CAD) without modifiable risk factors, coronary computed tomography angiography (CCTA) is an effective tool for determining the risk of heart attacks and other adverse cardiac events, according to a study published online Feb. 19 in Radiology.
Jonathon Leipsic, M.D., from the University of British Columbia in Vancouver, Canada, and colleagues identified 5,262 patients without known CAD and without modifiable risk factors undergoing coronary CT at 12 centers. On a per-patient, per-vessel, and per-segment basis, CAD severity was rated as none (0 percent), mild (1 percent to 49 percent), or obstructive (≥50 percent). The correlation between CAD presence, extent, and severity with MACE was assessed.
At a mean follow-up of 2.3 ± 1.2 years, the researchers found that 106 patients experienced MACE. Per-patient obstructive CAD was significantly related to MACE in risk-adjusted analysis (hazard ratio [HR], 6.64). There was a dose-response relationship between MACE and the number of vessels exhibiting obstructive CAD, with increasing risk for obstructive one-vessel (HR, 6.11), two-vessel (HR, 5.86), or three-vessel or left main (HR, 11.69) CAD. For both symptomatic and asymptomatic patients, the increased hazard for MACE of obstructive disease was observed (HRs, 11.9 and 6.3, respectively). The absence of CAD at CT angiography correlated with a low annualized rate of MACE (0.31 percent, versus 2.06 percent with obstructive disease).
"CCTA should be considered as an appropriate first-line test for patients with atypical chest pain and suspected but not confirmed coronary artery disease," Leipsic said in a statement.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.