RESUMO
Fundamento y objetivo: determinar la rentabilidad diagnóstica y pronóstica de la coronariografía no invasiva mediante tomografía computarizada con multidetectores (TCMD) en pacientes con clínica sospechosa de enfermedad arterial coronaria (EAC) y ergometría no diagnóstica. Pacientes y método: estudio retrospectivo de 33 pacientes en el que se evaluó en el seguimiento la necesidad de revascularización, hospitalización por infarto o angina, y muerte. Resultados: se observó que 7 (21%) pacientes tenían lesiones significativas; 18 (55%), no significativas, y 6 (18%) no tenían lesiones; en 2 (6%) pacientes la TCMD no fue cuantificable. La media (desviación estándar) de tiempo de seguimiento fue 21 (10) meses. Se registraron eventos en 5 (15%) pacientes: 4 revascularizaciones en el grupo de pacientes con lesiones significativas y 1 muerte por causa cardiovascular en el grupo de lesiones no significativas. No se produjeron eventos en los 6 pacientes sin lesiones coronarias ni en los 2 pacientes con TCMD no cuantificable. Conclusiones: los pacientes con sospecha clínica de EAC y ergometría no diagnóstica presentan gran prevalencia de EAC por TCMD y gran incidencia de eventos cardiovasculares a corto plazo. La gravedad de la enfermedad establecida con TCMD se relaciona con dichos eventos (AU)
Background and objective: We aimed to establish the diagnostic and prognostic usefulness of noninvasive coronary angiography using multidetector computer tomography (MDCT) in patients with clinical suspicion of coronary artery disease (CAD) and a non-diagnostic exercise treadmill test result. Patients and method: Retrospective analysis in 33 patients evaluating the incidence of revascularization and hospitalization due to myocardial infarction or angina, and death. Results: There were obstructive lesions in 7 (21%), non-obstructive lesions in 18 (55%), absence of lesions in 6 (18%), and, finally, 2 patients (6%) had an MDCT deemed as non-evaluable. The follow-up was extended up to 21 (10) months. Events appeared in 5 (15%) patients: 4 myocardial revascularizations in the group with obstructive coronary stenosis, and 1 cardiovascular death in the group with non-obstructive coronary lesions. No events were recorded among those 6 patients without coronary lesions nor in those 2 with non-evaluable MDCT studies. Conclusions: Patients with suspected CAD and a non-diagnostic exercise test present with a high prevalence of CAD when studied by MDCT and have a high incidence of cardiovascular events. The severity of stenosis as assessed by MDCT relates to cardiovascular events during the follow-up (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Angiografia Coronária/métodos , Doença das Coronárias/diagnóstico , Tomografia Computadorizada por Raios X , Seguimentos , Ergometria/métodos , Estudos Retrospectivos , Revascularização MiocárdicaRESUMO
BACKGROUND AND OBJECTIVE: We aimed to establish the diagnostic and prognostic usefulness of noninvasive coronary angiography using multidetector computer tomography (MDCT) in patients with clinical suspicion of coronary artery disease (CAD) and a non-diagnostic exercise treadmill test result. PATIENTS AND METHOD: Retrospective analysis in 33 patients evaluating the incidence of revascularization and hospitalization due to myocardial infarction or angina, and death. RESULTS: There were obstructive lesions in 7 (21%), non-obstructive lesions in 18 (55%), absence of lesions in 6 (18%), and, finally, 2 patients (6%) had an MDCT deemed as non-evaluable. The follow-up was extended up to 21 (10) months. Events appeared in 5 (15%) patients: 4 myocardial revascularizations in the group with obstructive coronary stenosis, and 1 cardiovascular death in the group with non-obstructive coronary lesions. No events were recorded among those 6 patients without coronary lesions nor in those 2 with non-evaluable MDCT studies. CONCLUSIONS: Patients with suspected CAD and a non-diagnostic exercise test present with a high prevalence of CAD when studied by MDCT and have a high incidence of cardiovascular events. The severity of stenosis as assessed by MDCT relates to cardiovascular events during the follow-up.
