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Long-term prognostic value of coronary computed tomography angiography in chest pain patients.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
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2019 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 60, no 1, p. 45-53Article in journal (Refereed) Published
Abstract [en]

Background Coronary computed tomography angiography (CCTA) is increasingly used to detect coronary artery disease (CAD), but long-term follow-up studies are still scarce. Purpose To evaluate the prognostic value of CCTA in patients with suspected CAD. Material and Methods A total of 1205 consecutive CCTA patients with chest pain were classified as normal coronary arteries, non-obstructive CAD, or obstructive CAD. The primary outcome was major adverse cardiac event (MACE), defined as a composite outcome including cardiac death, myocardial infarction, unstable angina pectoris, or late revascularization (after >90 days). Results Over 7.5 years follow-up (median = 3.1 years), Kaplan-Meier estimates demonstrated a MACE in 1.0%, 4.6%, and 20.7% in normal coronary arteries, non-obstructive CAD, and obstructive CAD, respectively. Log rank test for pairwise comparisons showed significant differences between non-obstructive CAD and normal coronary arteries ( P = 0.023) and between obstructive CAD and normal coronary arteries ( P < 0.001). In a multivariable analysis, adjusting for classical risk factors, non-obstructive CAD and obstructive CAD were independent predictors of MACE, with hazard ratios (HR) of 3.22 ( P = 0.041) and 25.18 ( P < 0.001), respectively. Conclusion Patients with normal coronary arteries have excellent long-term prognosis, but the risk for MACE increases with non-obstructive and obstructive CAD. Both non-obstructive and obstructive CAD are independently associated with future ischemic events.

Place, publisher, year, edition, pages
2019. Vol. 60, no 1, p. 45-53
Keywords [en]
CT, Cardiac, computed tomography angiography, epidemiology, ischemia/infarction
National Category
Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:liu:diva-149562DOI: 10.1177/0284185118773551ISI: 000453211800006PubMedID: 29742921OAI: oai:DiVA.org:liu-149562DiVA, id: diva2:1231281
Note

Funding  agencies:  ALF Grants, Region Ostergotland

Available from: 2018-07-06 Created: 2018-07-06 Last updated: 2019-01-07

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Sandstedt, MårtenDe Geer, JakobHenriksson, LilianEngvall, JanJanzon, MagnusPersson, AndersAlfredsson, Joakim
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Division of Radiological SciencesFaculty of Medicine and Health SciencesCenter for Medical Image Science and Visualization (CMIV)Department of Radiology in LinköpingDivision of Cardiovascular MedicineDepartment of Clinical Physiology in LinköpingDivision of Health Care AnalysisDepartment of Cardiology in Linköping
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