Differential Prognostic Value of Coronary Computed Tomography Angiography in Relation to Exercise Electrocardiography in Asymptomatic Subjects

Overview

Journal J Cardiovasc Ultrasound

Specialty Cardiology & Vascular Diseases

Date 2016 Jan 13

PMID 26755933

Citations 3

Authors

Sang-Eun Lee

Iksung Cho

Geu-Ru Hong

Hyuk-Jae Chang

Ji Min Sung

In-Jeong Cho

Chi Young Shim

Byoung Wook Choi

Namsik Chung

Affiliations

Soon will be listed here.

Abstract

Background: To explore the prognostic performance of coronary computed tomography angiography (CCTA) and exercise electrocardiography (XECG) in asymptomatic subjects.

Methods: We retrospectively enrolled 812 (59 ± 9 years, 60.8% male) asymptomatic subjects who underwent CCTA and XECG concurrently from 2003 through 2009. Subjects were followed-up for major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, unstable angina, and revascularization after 90 days from index CCTA.

Results: The prevalence of occult coronary artery disease (CAD) detected by CCTA was 17.5% and 120 subjects (14.8%) had positive XECG. During a mean follow-up of 37 ± 16 months, nine subjects experienced MACE. In multivariable Cox-regression analysis, only the presence of CAD by CCTA independently predicted future MACE (p = 0.002). Moreover, CAD by CCTA improved the predictive value when added to a clinical risk factor model using the likelihood ratio test (p < 0.001). Notably, the prognostic value of CCTA persisted in the moderate-to-high-risk group as classified by the Duke treadmill score (p = 0.040), but not in the low-risk group (p = 0.991).

Conclusion: CCTA provides incremental prognostic benefit over and above XECG in an asymptomatic population, especially for those in a moderate-to-high-risk group as classified by the Duke treadmill score. Risk stratification using XECG may prove valuable for identifying asymptomatic subjects who can benefit from CCTA.

Citing Articles

[Use of Coronary CT Angiography as a Screening Tool for Coronary Artery Disease in Asymptomatic Healthy Individuals or Patients].

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PMID: 36237344 PMC: 9238211. DOI: 10.3348/jksr.2021.0161.

Prognostic Impact of Nonobstructive Coronary Artery Disease Detected by Coronary Computed Tomographic Angiography.

Kosuta D, Jug B, Fras Z Angiology. 2021; 72(8):749-753.

PMID: 33739163 PMC: 8326899. DOI: 10.1177/0003319721999494.

Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study.

Cho I, AlAref S, Berger A, Hartaigh B, Gransar H, Valenti V Eur Heart J. 2018; 39(11):934-941.

PMID: 29365193 PMC: 6454496. DOI: 10.1093/eurheartj/ehx774.

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