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Current Cardiovascular Imaging Reports
Erschienen in: Current Cardiovascular Imaging Reports 6/2011

01.12.2011 | Cardiac Computed Tomography (Stephan Achenbach, Section Editor)

The Prognostic Value of Coronary CT Angiography

verfasst von: Edward A. Hulten, Michael Cheezum, Collin Fischer, Todd C. Villines

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 6/2011

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Abstract

Coronary CT angiography has gained increasingly widespread acceptance as a highly accurate method for the diagnosis of coronary artery disease. Beyond its usefulness as a diagnostic test to identify coronary artery stenoses in appropriately selected patients, multiple studies have consistently demonstrated that the extent and severity of coronary atherosclerosis visualized using coronary CT angiography conveys robust prognostic information. The majority of studies to date examining clinical outcomes following coronary CT angiography have documented coronary artery disease either as the presence of any coronary plaque or through the number of vessels with ≥50% (obstructive) stenosis. In the future, advanced, semi-quantitative measures of coronary atherosclerotic disease burden, plaque morphology, and composition may provide additional prognostic information. It is imperative that patients undergoing coronary CT angiography and their providers understand the prognostic information inherent to modern coronary CT angiography so that the maximal yield may be realized. Herein, we review the currently available prognostic studies of coronary CT angiography.
Literatur
1.
Mark DB, Nelson CL, Califf RM, et al. Continuing evolution of therapy for coronary artery disease. Initial results from the era of coronary angioplasty. Circulation. 1994;89:2015–25.PubMed
2.
Hachamovitch R, Di Carli MF. Methods and limitations of assessing new noninvasive tests: part II: outcomes-based validation and reliability assessment of noninvasive testing. Circulation. 2008;117:2793–801.PubMedCrossRef
3.
Schuetz GM, Zacharopoulou NM, Schlattmann P, Dewey M. Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging. Ann Intern Med. 2010;152:167–77
4.
•• Taylor AJ, Cerqueira M, Hodgson JM, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation appropriate use criteria task force, the society of cardiovascular computed tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for cardiovascular imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol. 2010;56:1864–94. Current multi-society Appropriate Use statement regarding the appropriate patient indications for cardiac CT.
5.
•• Min JK, Shaw LJ, Devereux RB, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol. 2007;50:1161–70. This article demonstrates the prognostic implications of coronary CT angiography for mortality based on stenosis severity and overall extent. PubMedCrossRef
6.
Ostrom MP, Gopal A, Ahmadi N, et al. Mortality incidence and the severity of coronary atherosclerosis assessed by computed tomography angiography. J Am Coll Cardiol. 2008;52:1335–43.PubMedCrossRef
7.
•• Chow BJ, Wells GA, Chen L, et al. Prognostic value of 64-slice cardiac computed tomography severity of coronary artery disease, coronary atherosclerosis, and left ventricular ejection fraction. J Am Coll Cardiol. 2010;55:1017–28. This article is the largest prospective study of the prognostic value of coronary CT angiography and the impact of left ventricular function on prognosis.
8.
•• Hulten EA, Carbonaro S, Petrillo SP, Mitchell JD, Villines TC. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;57:1237–47. This article is the first large meta-analysis to assess the prognostic value of coronary CT angiography and summarizes its prognostic value in over 9500 patients.
9.
Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–47.PubMed
10.
Metz LD, Beattie M, Hom R, Redberg RF, Grady D, Fleischmann KE. The prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography: a meta-analysis. J Am Coll Cardiol. 2007;49:227–37.PubMedCrossRef
11.
Shaw LJ, Wilson PWF, Hachamovitch R, Hendel RC, Borges-Neto S, Berman DS. Improved Near-term coronary artery disease risk classification with gated stress myocardial perfusion SPECT. J Am Coll Cardiol Img. 2010;3:1139–48
12.
Pagali SR, Madaj P, Gupta M, et al. Interobserver variations of plaque severity score and segment stenosis score in coronary arteries using 64 slice multidetector computed tomography: a substudy of the ACCURACY trial. J Cardiovasc Comput Tomogr. 4:312–8
13.
Voros S, Rinehart S, Qian Z, et al. Coronary atherosclerosis imaging by coronary CT angiography current status, correlation with intravascular interrogation and meta-analysis. JACC Cardiovasc Imaging. 2010;4:537–48
14.
Villines TC. Keeping score of coronary artery disease using cardiac CT angiography: can reasonable experts agree? J Cardiovasc Comput Tomogr. 2010;4:319–21
15.
• Min JK, Dunning A, Lin FY, et al. Rationale and design of the CONFIRM (COronary CT angiography evaluation for clinical outcomes: an international multicenter) registry. J Cardiovasc Comput Tomogr. 2011;5:84–92. This article describes the design of the international CONFIRM trial, an ongoing large study examining the prognostic implications of coronary CT angiography.
16.
Min JK, Dunning A, Achenbach S, et al. Abstract 14571: prognostic value of 64-detector row coronary CT angiography for the prediction of all-cause mortality: results from 21,062 patients in the prospective multinational CONFIRM registry (Coronary CT angiography evaluation for clinical outcomes: an international multicenter registry). Circulation. 2010;122:A14571
17.
2009 late-breaking clinical trial/science abstracts from the aha scientific sessions 2009. Circulation. 2009;120:2152–61
18.
• Schlett CL, Banerji D, Siegel E, et al. Prognostic value of CT angiography for major adverse cardiac events in patients with acute chest pain from the emergency department 2-year outcomes of the ROMICAT trial. JACC Cardiovasc Imaging. 2011;4:481–91. This article demonstrates the 2-year outcomes of patients with acute chest pain assessed with coronary CT angiography in the emergency department.
19.
Priest VL, Scuffham PA, Hachamovitch R, Marwick TH. Cost-effectiveness of coronary computed tomography and cardiac stress imaging in the emergency department a decision analytic model comparing diagnostic strategies for chest pain in patients at low risk of acute coronary syndromes. JACC Cardiovasc Imaging. 2011;4:549–56
20.
Goehler A, Ollendorf DA, Jaeger M, et al. A simulation model of clinical and economic outcomes of cardiac CT triage of patients with acute chest pain in the emergency department. AJR Am J Roentgenol. 2011;196:853–61
21.
Weustink AC, de Feyter PJ. Radiation exposure in cardiac multislice spiral computed tomography (MSCT). F1000 Med Rep 2009;1
22.
Nieman K, Pattynama PM, Rensing BJ, Van Geuns RJ, De Feyter PJ. Evaluation of patients after coronary artery bypass surgery: CT angiographic assessment of grafts and coronary arteries. Radiology. 2003;229:749–56.PubMedCrossRef
23.
• Chow BJ, Ahmed O, Small G, et al. Prognostic value of CT angiography in coronary bypass patients. JACC Cardiovasc Imaging. 2011;4:496–502. This article demonstrates for the first time the prognostic information derived from coronary CT angiography among patients with prior coronary artery bypass surgery.
24.
Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol. 2006;47:C13–8.PubMedCrossRef
25.
Stone GW, Maehara A, Lansky AJ, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226–35
26.
Carrascosa PM, Capunay CM, Garcia-Merletti P, Carrascosa J, Garcia MF. Characterization of coronary atherosclerotic plaques by multidetector computed tomography. Am J Cardiol. 2006;97:598–602.PubMedCrossRef
27.
Motoyama S, Kondo T, Anno H, et al. Atherosclerotic plaque characterization by 0.5-mm-slice multislice computed tomographic imaging. Circ J. 2007;71:363–6.PubMedCrossRef
28.
Petranovic M, Soni A, Bezzera H, et al. Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: evaluation of nonculprit coronary lesions. J Cardiovasc Comput Tomogr. 2009;3:24–31.PubMedCrossRef
29.
Pohle K, Achenbach S, Macneill B, et al. Characterization of non-calcified coronary atherosclerotic plaque by multi-detector row CT: comparison to IVUS. Atherosclerosis. 2007;190:174–80.PubMedCrossRef
30.
Schroeder S, Kopp AF, Baumbach A, et al. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol. 2001;37:1430–5.PubMedCrossRef
31.
Sun J, Zhang Z, Lu B, et al. Identification and quantification of coronary atherosclerotic plaques: a comparison of 64-MDCT and intravascular ultrasound. AJR Am J Roentgenol. 2008;190:748–54.PubMedCrossRef
32.
Pflederer T, Marwan M, Schepis T, et al. Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography. Atherosclerosis. 2010;211:437–44.PubMedCrossRef
33.
Hammer-Hansen S, Kofoed KF, Kelbaek H, et al. Volumetric evaluation of coronary plaque in patients presenting with acute myocardial infarction or stable angina pectoris-a multislice computerized tomography study. Am Heart J. 2009;157:481–7.PubMedCrossRef
34.
Hoffmann U, Moselewski F, Nieman K, et al. Noninvasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions instable angina by multidetector computed tomography. J Am Coll Cardiol. 2006;47:1655–62.PubMedCrossRef
35.
Imazeki T, Sato Y, Inoue F, et al. Evaluation of coronary artery remodeling in patients with acute coronary syndrome and stable angina by multislice computed tomography. Circ J. 2004;68:1045–50.PubMedCrossRef
36.
Sato A, Ohigashi H, Nozato T, et al. Coronary artery spatial distribution, morphology, and composition of nonculprit coronary plaques by 64-slice computed tomographic angiography in patients with acute myocardial infarction. Am J Cardiol. 2010;105:930–5
37.
• Motoyama S, Kondo T, Sarai M, et al. Multislice computed tomographic characteristics of coronary lesions in acute coronary syndromes. J Am Coll Cardiol. 2007;50:319–26. This article describes plaque characteristics of culprit lesion in patients with acute coronary syndromes. PubMedCrossRef
38.
Schuijf JD, Beck T, Burgstahler C, et al. Differences in plaque composition and distribution in stable coronary artery disease versus acute coronary syndromes; non-invasive evaluation with multi-slice computed tomography. Acute Card Care. 2007;9:48–53.PubMedCrossRef
39.
Inoue F, Sato Y, Matsumoto N, Tani S, Uchiyama T. Evaluation of plaque texture by means of multislice computed tomography in patients with acute coronary syndrome and stable angina. Circ J. 2004;68:840–4.PubMedCrossRef
40.
Kunimasa T, Sato Y, Sugi K, Moroi M. Evaluation by multislice computed tomography of atherosclerotic coronary artery plaques in non-culprit, remote coronary arteries of patients with acute coronary syndrome. Circ J. 2005;69:1346–51.PubMedCrossRef
41.
Pundziute G, Schuijf JD, Jukema JW, et al. Head-to-head comparison of coronary plaque evaluation between multislice computed tomography and intravascular ultrasound radiofrequency data analysis. JACC Cardiovasc Interv. 2008;1:176–82.PubMedCrossRef
42.
Henneman MM, Schuijf JD, Pundziute G, et al. Noninvasive evaluation with multislice computed tomography in suspected acute coronary syndrome: plaque morphology on multislice computed tomography versus coronary calcium score. J Am Coll Cardiol. 2008;52:216–22.PubMedCrossRef
43.
•• Motoyama S, Sarai M, Harigaya H, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49–57. This study demonstrates plaque features associated with patients presenting with acute coronary syndrome. PubMedCrossRef
44.
Kashiwagi M, Tanaka A, Kitabata H, et al. Feasibility of noninvasive assessment of thin-cap fibroatheroma by multidetector computed tomography. JACC Cardiovasc Imag. 2009;2:1412–9.CrossRef
45.
Ito T, Terashima M, Kaneda H, et al. Comparison of in vivo assessment of vulnerable plaque by 64-slice multislice computed tomography versus optical coherence tomography. Am J Cardiol. 2011;107:1270–7.PubMedCrossRef
46.
Uetani T, Amano T, Kunimura A, et al. The association between plaque characterization by CT angiography and post-procedural myocardial infarction in patients with elective stent implantation. JACC Cardiovasc Imag. 2010;3:19–28.CrossRef
47.
Harigaya H, Motoyama S, Sarai M, et al. Prediction of the no-reflow phenomenon during percutaneous coronary intervention using coronary computed tomography angiography. Heart Vessels. 2011;26:363–9.
48.
Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med. 2007;356:2388–98.PubMedCrossRef
49.
Muller-Nordhorn J, Binting S, Roll S, Willich SN. An update on regional variation in cardiovascular mortality within Europe. Eur Heart J. 2008;29:1316–26.PubMedCrossRef
50.
Yach D, Hawkes C, Gould CL, Hofman KJ. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA. 2004;291:2616–22.PubMedCrossRef
51.
Murabito JM, Evans JC, Larson MG, Levy D. Prognosis after the onset of coronary heart disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation. Circulation. 1993;88:2548–55.PubMed
52.
Rose G. Strategy of prevention: lessons from cardiovascular disease. Br Med J (Clin Res Ed). 1981;282:1847–51.CrossRef
53.
Budoff MJ, Nasir K, McClelland RL, et al. Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2009;53:345–52.PubMedCrossRef
54.
Taylor AJ, Bindeman J, Feuerstein I, Cao F, Brazaitis M, O'Malley PG. Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: mean three-year outcomes in the Prospective Army Coronary Calcium (PACC) project. J Am Coll Cardiol. 2005;46:807–14.PubMedCrossRef
55.
Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA. 2004;291:210–5.PubMedCrossRef
56.
• Polonsky TS, McClelland RL, Jorgensen NW, et al. Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA. 2010;303:1610–6. This article demonstrates that coronary artery calcium scoring reclassifies a significant proportion of patients initially assessed using Framingham risk scoring alone.
57.
• Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2010;122:e584–636. This article is the current guideline outline recommendations for cardiovascular risk screening.
58.
Perrone-Filardi P, Achenbach S, Mohhlenkamp S, et al. Cardiac computed tomography and myocardial perfusion scintigraphy for risk stratification in asymptomatic individuals without known cardiovascular disease: a position statement of the Working Group on Nuclear Cardiology and Cardiac CT of the European Society of Cardiology. Eur Heart J. 2010.
59.
Achenbach S, Marwan M, Ropers D, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J. 2010;31:340–6
60.
Greenland P, Alpert JS, Beller GA, et al. ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010;56:e50–e103.PubMedCrossRef
61.
Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–23.PubMedCrossRef
62.
Choi EK, Choi SI, Rivera JJ, et al. Coronary computed tomography angiography as a screening tool for the detection of occult coronary artery disease in asymptomatic individuals. J Am Coll Cardiol. 2008;52:357–65.PubMedCrossRef
63.
Hadamitzky M, Meyer T, Hein F, et al. Prognostic value of coronary computed tomographic angiography in asymptomatic patients. Am J Cardiol. 2010;105:1746–51
64.
McEvoy JW, Blaha MJ, Nasir K, et al. Impact of coronary computed tomographic angiography results on patient and physician behavior in a low-risk population. Arch Intern Med. 2011;171:1260–8.
65.
Raggi P, Cooil B, Callister TQ. Use of electron beam tomography data to develop models for prediction of hard coronary events. Am Heart J. 2001;141:375–82.PubMedCrossRef
66.
Bild DE, Detrano R, Peterson D, et al. Ethnic differences in coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2005;111:1313–20.PubMedCrossRef
Metadaten
Titel
The Prognostic Value of Coronary CT Angiography
verfasst von
Edward A. Hulten
Michael Cheezum
Collin Fischer
Todd C. Villines
Publikationsdatum
01.12.2011
Verlag
Current Science Inc.
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 6/2011
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-011-9107-3

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