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Multi-slice computed tomography coronary angiography for risk stratification in patients with an intermediate pre-test likelihood
Heart, 07/23/09

Werkhoven JV et al. - Data suggest that in an intermediate pre-test likelihood population, MSCTA is highly effective in re-stratifying patients into either a low or high post-test risk group; further emphasizing the usefulness of non-invasive imaging with MSCTA in this patient population.

• Aim was to assess whether MSCTA may be useful for risk stratification of pts with suspected CAD at intermediate pre-test likelihood
• MSCTA images were evaluated for the presence of CAD in 316 pts (60% male, average age 57±11 yrs) with suspected CAD and an intermediate pre-test liklihood
• Pts were followed in time for the occurrence of an event
• Main outcome measures: A combined endpoint of all cause mortality, non-fatal infarction, and unstable angina requiring revascularization

• Significant CAD was observed in 28% pts, whereas normal MSCTA or non-significant CAD was observed in the remaining
• During f/u (median 621 days) an event occurred in 4.8% pts
• The annualized event rate was 0.8% in pts with normal MSCT, 2.2% in pts with non-significant CAD and 6.5% in pts with significant CAD
• Moreover, MSCTA remained a significant predictor of events after multivariate correction

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