CT coronary angiography provided independent, incremental information in patients with suspected CAD

Russo V. Circ Cardiovasc Imaging. 2010;3:351-359.

Issue: October 2010

Multidetector CT coronary angiography is capable of delivering independent and incremental information in a patient population with suspected coronary artery disease, including showing an association between the disease and hard cardiac events, new study data have indicated.

The study consisted of 441 patients (mean age, 59.7 ± 11.6 years) with suspected CAD. Physicians performed multidetector CT coronary angiography to evaluate the presence and severity of the disease and followed up to determine the occurrence of hard cardiac events, including cardiac death, nonfatal MI and unstable angina requiring hospitalization.

Researchers detected coronary lesions in 297 (67.3%) patients. During follow-up (mean 31.9 ± 14.8 months), they reported 44 hard cardiac events in 40 patients. There was a statistically significant incremental prognostic value in CT calcium scoring vs. a baseline clinical risk model (P=.018). However, multidetector CT coronary angiography provided an additional incremental prognostic value vs. a baseline clinical risk model plus calcium scoring if considering both non-obstructive vs. obstructive CAD (P=.016) or plaque composition (calcified vs. noncalcified and/or mixed plaques, P=.0001).

According to researchers, the presence of noncalcified or mixed plaques, regardless of lesion severity, was found to be the strongest predictor of events (P<.0001) as a potential marker of plaque vulnerability.

“According to these results, multidetector CT has been confirmed as an extremely accurate noninvasive tool in coronary artery evaluation, capable of providing information about two of the most significant independent predictors of hard cardiac events — the presence and severity of CAD and the composition of atherosclerotic plaques,” they wrote.

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