Differential Prognostic Value of Coronary Computed Tomography Angiography in Relation to Exercise Electrocardiography in Asymptomatic Subjects
Journal of Cardiovascular Ultrasound
;
: 244-252, 2015.
Article
in English
| WPRIM
| ID: wpr-58197
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Coronary Artery Disease
/
Angiography
/
Prevalence
/
Retrospective Studies
/
Risk Factors
/
Follow-Up Studies
/
Death
/
Electrocardiography
/
Angina, Unstable
/
Myocardial Infarction
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Journal of Cardiovascular Ultrasound
Year:
2015
Type:
Article
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