OBJECTIVES: This study investigated whether cardiac computed tomography angiography (CTA) can predict all-cause mortality in symptomatic patients. BACKGROUND: Noninvasive coronary angiography is being increasingly performed by CTA to assess for obstructive coronary artery disease (CAD), and minimal outcome data exist for coronary CTA. We have utilized a cohort of symptomatic patients who underwent electron beam tomography to allow for longer follow-up (up to 12 years) than currently available with newer 64-slice multidetector-row computed tomography studies. METHODS: In all, 2,538 consecutive patients who underwent CTA by electron beam tomography (age 59 +/- 14 years, 70% males) without known CAD were studied. Computed tomographic angiography results were categorized as significant CAD (> or =50% luminal narrowing), mild CAD (<50% stenosis), and normal coronary arteries. Multivariable Cox proportional hazards models were developed to predict all-cause mortality. Risk-adjusted models incorporated traditional risk factors for coronary disease and coronary artery calcification (CAC). RESULTS: During a mean follow-up of 78 +/- 12 months, the death rate was 3.4% (86 deaths). The CTA-diagnosed CAD was an independent predictor of mortality in a multivariable model adjusted for age, gender, cardiac risk factors, and CAC (p < 0.0001). The addition of CAC to CTA-diagnosed CAD increased the concordance index significantly (0.69 for risk factors, 0.83 for the CTA-diagnosed CAD, and 0.89 for the addition of CAC to CAD, p < 0.0001). Risk-adjusted hazard ratios for CTA-diagnosed CAD were 1.7-, 1.8-, 2.3-, and 2.6-fold for 3-vessel nonobstructive, 1-vessel obstructive, 2-vessel obstructive, and 3-vessel obstructive CAD, respectively (p < 0.0001), when compared with the group who did not have CAD. CONCLUSIONS: The primary results of our study reveal that the burden of angiographic disease detected by CTA provides both independent and incremental value in predicting all-cause mortality in symptomatic patients independent of age, gender, conventional risk factors, and CAC.
OBJECTIVES: This study investigated whether cardiac computed tomography angiography (CTA) can predict all-cause mortality in symptomatic patients. BACKGROUND: Noninvasive coronary angiography is being increasingly performed by CTA to assess for obstructive coronary artery disease (CAD), and minimal outcome data exist for coronary CTA. We have utilized a cohort of symptomatic patients who underwent electron beam tomography to allow for longer follow-up (up to 12 years) than currently available with newer 64-slice multidetector-row computed tomography studies. METHODS: In all, 2,538 consecutive patients who underwent CTA by electron beam tomography (age 59 +/- 14 years, 70% males) without known CAD were studied. Computed tomographic angiography results were categorized as significant CAD (> or =50% luminal narrowing), mild CAD (<50% stenosis), and normal coronary arteries. Multivariable Cox proportional hazards models were developed to predict all-cause mortality. Risk-adjusted models incorporated traditional risk factors for coronary disease and coronary artery calcification (CAC). RESULTS: During a mean follow-up of 78 +/- 12 months, the death rate was 3.4% (86 deaths). The CTA-diagnosed CAD was an independent predictor of mortality in a multivariable model adjusted for age, gender, cardiac risk factors, and CAC (p < 0.0001). The addition of CAC to CTA-diagnosed CAD increased the concordance index significantly (0.69 for risk factors, 0.83 for the CTA-diagnosed CAD, and 0.89 for the addition of CAC to CAD, p < 0.0001). Risk-adjusted hazard ratios for CTA-diagnosed CAD were 1.7-, 1.8-, 2.3-, and 2.6-fold for 3-vessel nonobstructive, 1-vessel obstructive, 2-vessel obstructive, and 3-vessel obstructive CAD, respectively (p < 0.0001), when compared with the group who did not have CAD. CONCLUSIONS: The primary results of our study reveal that the burden of angiographic disease detected by CTA provides both independent and incremental value in predicting all-cause mortality in symptomatic patients independent of age, gender, conventional risk factors, and CAC.
Authors: E Maffei; S Seitun; C Martini; A Aldrovandi; T Arcadi; A Clemente; G Messalli; R Malagò; A Weustink; N Mollet; K Nieman; D Ardissino; P de Feyter; G Krestin; F Cademartiri Journal: Radiol Med Date: 2010-10-06 Impact factor: 3.469
Authors: Annika Schuhbäck; Mohamed Marwan; Sören Gauss; Gerd Muschiol; Dieter Ropers; Christian Schneider; Michael Lell; Johannes Rixe; Christian Hamm; Werner G Daniel; Stephan Achenbach Journal: Eur Radiol Date: 2012-03-27 Impact factor: 5.315
Authors: Rachel S Newson; Jacqueline C M Witteman; Oscar H Franco; Bruno H C Stricker; Monique M B Breteler; Albert Hofman; Henning Tiemeier Journal: Age (Dordr) Date: 2010-06-01
Authors: Ilan Gottlieb; Julie M Miller; Armin Arbab-Zadeh; Marc Dewey; Melvin E Clouse; Leonardo Sara; Hiroyuki Niinuma; David E Bush; Narinder Paul; Andrea L Vavere; John Texter; Jeffery Brinker; João A C Lima; Carlos E Rochitte Journal: J Am Coll Cardiol Date: 2010-02-16 Impact factor: 24.094