PT  - JOURNAL ARTICLE
AU  - Ronny R Buechel
AU  - Aju P Pazhenkottil
AU  - Bernhard A Herzog
AU  - Michael Brueckner
AU  - Rene Nkoulou
AU  - Jelena R Ghadri
AU  - Silke M Küest
AU  - Christophe A Wyss
AU  - Lars Husmann
AU  - Philipp A Kaufmann
TI  - Prognostic performance of low-dose coronary CT angiography with prospective ECG triggering
AID  - 10.1136/hrt.2010.217638
DP  - 2011 Sep 01
TA  - Heart
PG  - 1385--1390
VI  - 97
IP  - 17
4099  - http://heart.bmj.com/content/97/17/1385.short
4100  - http://heart.bmj.com/content/97/17/1385.full
SO  - Heart2011 Sep 01; 97
AB  - 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.