 |
|
Midterm Prognosis of Patients With Suspected Coronary Artery Disease and Normal Multislice Computed Tomographic FindingsA Prospective Management Outcome Study
Martine Gilard, MD;
Grégoire Le Gal, MD;
Jean-Christophe Cornily, MD;
Ulrich Vinsonneau, MD;
Cédric Joret, MD;
Pierre-Yves Pennec, MD;
Jacques Mansourati, MD;
Jacques Boschat, MD
Arch Intern Med. 2007;167(15):1686-1689.
Background The gold standard test for the diagnosis of coronary artery disease (CAD) is conventional coronary angiography (C-CAG). Lately, multislice computed tomographic coronary angiography (MSCT-CAG) demonstrated a high sensitivity and a negative predictive value for a CAD primary diagnosis when compared with C-CAG. The aim of our study is to prospectively assess the safety of ruling out CAD based solely on a normal MSCT-CAG result.
Methods From June 15, 2004, to January 20, 2006, consecutive patients initially scheduled for C-CAG for a primary diagnosis of CAD underwent MSCT-CAG instead. Patients with a highly calcified coronary network or with an abnormal or a noninterpretable MSCT-CAG result underwent secondary C-CAG and were excluded from the study. We included patients whose diagnosis of CAD was ruled out by a normal MSCT-CAG result; in those patients, C-CAG was not performed. All patients underwent further follow-up with clinical end points (death, subsequent C-CAG, and myocardial infarction).
Results In 141 patients, MSCT-CAG results were considered normal. During the follow-up period (mean, 14.7 months), those patients experienced 0% mortality, a 3.5% rate of subsequent C-CAG, and a 0.7% rate of myocardial infarction. The risks of subsequent death, new referral for C-CAG, or coronary events compare favorably with those following normal C-CAG, which were 0.4%, 4.3%, and 0.6%, respectively.
Conclusions Multislice computed tomographic CAG safely rules out CAD in patients with suspected disease and allows patients to be managed less invasively, by reducing the number in whom C-CAG has to be performed.
Author Affiliations: Department of Cardiology (Drs Gilard, Cornily, Vinsonneau, Joret, Pennec, Mansourati, and Boschat) and Division EA3878, Department of Internal Medicine and Chest Diseases (Dr Le Gal), Brest University Hospital, Brest, France.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
CT of Coronary Artery Disease
Bastarrika et al.
Radiology 2009;253:317-338.
ABSTRACT
| FULL TEXT
Risk Assessment and Predictive Value of Coronary Artery Disease Testing
Shaw and Narula
JNM 2009;50:1296-1306.
ABSTRACT
| FULL TEXT
Prognostic Value of Coronary Computed Tomographic Angiography for Prediction of Cardiac Events in Patients With Suspected Coronary Artery Disease
Hadamitzky et al.
J Am Coll Cardiol Img 2009;2:404-411.
ABSTRACT
| FULL TEXT
Bridging the Detection Gap Chasm of Risk: Where Can Computed Tomography Angiography Take Us?
Shaw and Narula
J Am Coll Cardiol Img 2009;2:524-526.
FULL TEXT
Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study.
Meijboom et al.
J Am Coll Cardiol 2008;52:2135-2144.
ABSTRACT
| FULL TEXT
Mortality Incidence and the Severity of Coronary Atherosclerosis Assessed by Computed Tomography Angiography
Ostrom et al.
J Am Coll Cardiol 2008;52:1335-1343.
ABSTRACT
| FULL TEXT
Assessing the Prognostic Value of Coronary Computed Tomography Angiography
Achenbach
J Am Coll Cardiol 2008;52:1344-1346.
FULL TEXT
Comprehensive Assessment of Coronary Artery Stenoses: Computed Tomography Coronary Angiography Versus Conventional Coronary Angiography and Correlation With Fractional Flow Reserve in Patients With Stable Angina
Meijboom et al.
J Am Coll Cardiol 2008;52:636-643.
ABSTRACT
| FULL TEXT
Cardiac CT and CT coronary angiography: technology and application
Roberts et al.
Heart 2008;94:781-792.
ABSTRACT
| FULL TEXT
Screening High-Risk Patients With Computed Tomography Angiography
Gottlieb and Lima
Circulation 2008;117:1318-1332.
FULL TEXT
|
