Abstract:

Objective To evaluate forecast value of coronary computed tomography angiography (CTCA) for prognosis of patients with non-significant coronary stenosis. Methods Patients with suspected coronary artery disease underwent CTCA were enrolled and followed up. Cardiovascular clinical endpoints were defined as major adverse cardiac event (MACE) including cardiac death, nonfetal myocardial infarction, and hospitalization due to chest pain. The relationships between MACE and baseline patient characteristics, stenosis severity, and lesion characteristics were evaluated respectively. Results A total of 847 patients (53.8% males) were enrolled, whose mean age was (61.7±12.7) years. CTCA results showed normal lumen in 61.3% patients, mild stenosis in 22.2%, and moderate stenosis in 16.5% patients. During follow-up of (20.3±2.2) months, MACE rate was 1.5%. Multivariate COX hazard regression analysis showed that the severity of lesion in coronary CTCA was the only factor causing MACE (HR=4.43, 95%CI: 1.78-11.05, P<0.01). Compared to patients without coronary lesions, more MACEs occurred in patients with coronary lesions (P<0.001). Conclusion MACE rate in patients with non-significant coronary stenosis detected by CTCA was correlated well to the severity of lesion, while MACE rate was very low in patients with normal and mild coronary lesion.

Key words: computed tomography, coronary artery disease, prognosis