Long-term prognosis evaluation value of normal coronary computed tomography angiography in patients with suspected coronary heart disease / 中国医师进修杂志

ABSTRACT

Objective:To explore the long-term prognosis evaluation value and risk factors of normal coronary computed tomography angiography (CCTA) in patients with suspected coronary heart disease (CHD).Methods:The clinical data of 332 patients with suspected CAD from June 2006 to July 2017 in the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed. All patients received more than 2 times of CCTA examination, and the baseline CCTA was normal. Patients were followed up for at least 4 years, and the endpoints were coronary neo-plaque on CCTA or cardiovascular events.Results:Among 332 patients, the interval time between baseline and follow-up CCTA and clinical follow-up time were (5.6 ± 0.5) and (9.8 ± 0.6) years, 304 patients had normal baseline and follow-up CCTA (group Ⅰ); 28 patients had normal baseline CCTA while abnormal follow-up (group Ⅱ), the patient found coronary neo-plaque, and the incidence of coronary neo-plaque was 8.4% (28/332). Two patients (0.6%, 2/332) suffered from cardiovascular events, all of whom were in group Ⅱ. In group Ⅱ, a total of 34 coronary neo-plaques were found on follow-up CCTA. Multivariate Logistic regression analysis results showed that smoking, hypertension and hyperlipidemia were the independent risk factors of normal baseline while follow-up CCTA with neo-plaque in patients with suspected CAD ( β = 0.84, 0.83 and 0.84; OR = 2.37, 2.32 and 2.33; P<0.01). Conclusions:The suspected CAD patients with normal baseline CCTA have a good long-term prognosis. However, the patients who have risk factors such as smoking, hypertension and hyperlipidemia should be taken seriously, especially the patients who have normal baseline while follow-up CCTA with neo-plaque.