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.
Authors: Olivier F Clerc; Basil P Kaufmann; Mathias Possner; Riccardo Liga; Jan Vontobel; Fran Mikulicic; Christoph Gräni; Dominik C Benz; Tobias A Fuchs; Julia Stehli; Aju P Pazhenkottil; Oliver Gaemperli; Philipp A Kaufmann; Ronny R Buechel Journal: Eur Radiol Date: 2017-05-12 Impact factor: 5.315
Authors: Georgios Benetos; Ronny R Buechel; Marisa Gonçalves; Dominik C Benz; Elia von Felten; Georgios P Rampidis; Olivier F Clerc; Michael Messerli; Andreas A Giannopoulos; Cathérine Gebhard; Tobias A Fuchs; Aju P Pazhenkottil; Philipp A Kaufmann; Christoph Gräni Journal: Int J Cardiovasc Imaging Date: 2020-01-01 Impact factor: 2.357