Gorgi Kozeski, DO1, Hormoz Kianfar, MD1, M. Rizwan Khalid, MD2, Fatima R. Khalid, MD2, William Tenet, MD3, Ola Akinboboye, MD1
1New York Hospital Medical Center Queens, Flushing, New York, 2Emory University, Atlanta, Georgia, 3Cardiovascular Associates of New York
Background: Multislice cardiac CT angiography (MSCT) has emerged as a useful non-invasive modality for the diagnosis of the presence and severity of obstructive coronary artery disease (CAD). Its diagnostic accuracy for detecting CAD in patients with chest pain syndrome and suspected CAD has been well validated, however, data on the prognostic value of MSCT for the prediction of adverse cardiac events is limited. We sought to evaluate the prognostic value of MSCT based on mortality in patients with suspected or established CAD.
Methods: We performed an observational analysis of 225 patients referred for MSCT in an outpatient cardiology practice from November 2005 to June 2008. In all patients, 64-slice MSCT coronary angiography was performed using standard protocol. All examinations were performed using dual-source Siemens CT scanner (Siemens Medical Solutions, Forchheim, Germany). Social security death index was used to determine mortality.
Results: Chest pain, asymptomatic CAD and an equivocal stress study were the most common indications for MSCT. Average age of our cohort was 64 ± 12 with males constituting 58%. Sixty-one percent had history of hypertension, 27% had dyslipidemia, 14% had diabetes mellitus, 6% were current smokers, and 47% had family history of premature CAD. Twenty-four percent had established CAD prior to MSCT evaluation. Mean follow-up was 19 months ± 4 months. We observed one mortality during the 19-month follow-up period. Event-free survival was 99.6%.
Conclusions: In our single center study, Multislice Cardiac CT Angiography had an excellent prognostic value in regards to mortality with a death in one out of 225 patients with an event-free survival of 99.6% during a follow-up period of 19 months.