International Journal of Anatomy Radiology and Surgery (Jul 2020)

Prospective Study on Clinical Outcome of Coronary CT Angiography in Patients with Suspected Coronary Artery Disease: Three-year Follow-up Study

  • K SUNIL KUMAR,
  • J NAVEEN,
  • RIMIKI CHALLAM,
  • S SUBHASCHANDRA

DOI
https://doi.org/10.7860/IJARS/2020/44191:2558
Journal volume & issue
Vol. 9, no. 3
pp. 04 – 06

Abstract

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Introduction: Coronary Artery Disease (CAD) is one of the leading causes of morbidity and mortality in India. Coronary Computed Tomography Angiogram (CTA) is a non-invasive imaging modality for evaluation of CAD and has high accuracy in ruling out significant CAD. The prognostic value of CTA is less established. Aim: To assess the clinical outcome of CTA in patients with suspected CAD. Materials and Methods: Total of 30 patients with suspected CAD underwent CTA for evaluation of coronary arteries. Patients were categorised as normal, non-significant stenosis (50% luminal stenosis) on CTA findings. All patients were followed up for three years for occurrence of adverse cardiac events. Fischer’s-exact test was used to see the association between calcium score and occurrence of adverse cardiac events and to see the association between the groups of patients and the adverse event outcome. The p-value <0.05 was considered as statistically significant. Cumulative adverse cardiac event rates as a function over time (follow-up period) were estimated according to the KaplanMeier method and survival curves of the composite end points were compared using the log-rank test. Results: CTA was normal in 19 (63.3%) patients, 5 (16.7%) patients had non-significant stenosis and remaining 6 (20.0%) had significant stenosis. No adverse cardiac events were reported in patients with normal CTA and non-significant stenosis. Four patients (66.7%) out of six with significant stenosis required revascularisation on follow-up. Cardiac events in patients with calcium score more than zero (36.4%) were significantly higher compared to those with zero calcium score (0.0%) (p<0.05). The event free survival was significantly higher among those with normal and non-significant stenosis compared to those with significant stenosis. Conclusion: In patients with suspected CAD, patients with normal coronary arteries or non-obstructive CAD on CTA showed excellent prognosis with no adverse cardiac events on follow-up.

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