CT Angiography IDs Future Heart Problems

More than just a diagnostic tool to determine whether or not a patient has coronary artery disease, coronary CT angiography (CCTA) can help physicians predict a patient’s risk of future cardiac problems, according to a study published online in the Journal of the American College of Cardiology.

The study, led by Fabian Bamberg, MD, MPH, of Ludwig-Maximilians University and Massachusetts General Hospital/Harvard Medical School, is a meta-analysis of 11 articles including 7,335 participants (average age 59.1 years, 62.8 percent male) from studies in PubMed, EMBASE and the Cochrane Library through January 2010. The studies involved patients with suspected heart disease, followed up with more than 100 subjects for more than a year, and reported elevated risk of subsequent heart issues in areas of interest to the researchers.

Strikingly the researchers found that one or more CCTA-spotted stenoses of 50 percent or greater led to a more than tenfold higher risk of subsequent events in studies that included data on revascularization. In studies excluding revascularization, patients with similar stenosis had a more than six-fold risk of subsequent events.

The study found that CCTA’s predictive value was solid even when adjusting for coronary calcification. Patients found to have arterial plaque were 4.5 times more likely to have had a future coronary event, the data showed.

The presence and extent of coronary artery disease on CCTA are “strong, independent predictors of cardiovascular events despite heterogeneity in endpoints, categorization of computed tomography findings, and study population,” the authors conclude.

Reference: J Am Coll Cardiol, 2011; 57:2426-2436, doi:10.1016/j.jacc.2010.12.043

Link: http://content.onlinejacc.org/cgi/content/abstract/57/24/2426