Coronary Computed Tomographic Angiography Imaging as a Prognostic Indicator for Coronary Artery Disease: Data from a Lebanese Tertiary Center.
Computed tomography angiography
Lebanon
coronary artery disease
myocardial infarction
prognosis
Journal
Heart views : the official journal of the Gulf Heart Association
ISSN: 1995-705X
Titre abrégé: Heart Views
Pays: India
ID NLM: 101316474
Informations de publication
Date de publication:
Historique:
received:
19
05
2020
accepted:
27
10
2020
entrez:
14
5
2021
pubmed:
15
5
2021
medline:
15
5
2021
Statut:
ppublish
Résumé
Coronary artery disease (CAD) is a major cause of death and disability worldwide. Coronary computed tomographic angiography (CCTA) is a noninvasive imaging technique with a high negative predictive value (NPV). Most studies were done in developed countries, where the prevalence of CAD does not reflect the actual disease burden in developing countries, such as Lebanon. We retrospectively evaluated the prognostic value of CCTA in predicting acute myocardial events (AMEs) in 200 Lebanese patients. We determined if specific medical and radiological characteristics are linked with AME and looked for any association between the patient's medical risk factors and the type/location of detected atheromatous plaques. Patients' records were reviewed, and the follow-up period of 5-8 years ensued. Chi-square/Fisher test and Student's Our study showed that CCTA had a NPV that reaches 97.9% in asymptomatic patients, a positive predictive value (PPV) of 76.4% for symptomatic patients, a sensitivity of 88.9%, and a specificity of 52.5%. AMEs were significantly increased in patients with a mixed plaque type and/or a moderate-to-severe lumen reduction on CCTA. CCTA is a sensitive modality for plaque detection and is found to have a remarkably high NPV for asymptomatic patients. A CCTA, along with a low pretest clinical probability of CAD, can be sufficient to rule out an AME for up to 8 years.
Sections du résumé
BACKGROUND
BACKGROUND
Coronary artery disease (CAD) is a major cause of death and disability worldwide. Coronary computed tomographic angiography (CCTA) is a noninvasive imaging technique with a high negative predictive value (NPV). Most studies were done in developed countries, where the prevalence of CAD does not reflect the actual disease burden in developing countries, such as Lebanon.
METHODS
METHODS
We retrospectively evaluated the prognostic value of CCTA in predicting acute myocardial events (AMEs) in 200 Lebanese patients. We determined if specific medical and radiological characteristics are linked with AME and looked for any association between the patient's medical risk factors and the type/location of detected atheromatous plaques. Patients' records were reviewed, and the follow-up period of 5-8 years ensued. Chi-square/Fisher test and Student's
RESULTS
RESULTS
Our study showed that CCTA had a NPV that reaches 97.9% in asymptomatic patients, a positive predictive value (PPV) of 76.4% for symptomatic patients, a sensitivity of 88.9%, and a specificity of 52.5%. AMEs were significantly increased in patients with a mixed plaque type and/or a moderate-to-severe lumen reduction on CCTA.
CONCLUSIONS
CONCLUSIONS
CCTA is a sensitive modality for plaque detection and is found to have a remarkably high NPV for asymptomatic patients. A CCTA, along with a low pretest clinical probability of CAD, can be sufficient to rule out an AME for up to 8 years.
Identifiants
pubmed: 33986921
doi: 10.4103/HEARTVIEWS.HEARTVIEWS_87_20
pii: HV-21-239
pmc: PMC8104316
doi:
Types de publication
Journal Article
Langues
eng
Pagination
239-244Informations de copyright
Copyright: © 2021 Heart Views.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Circulation. 1998 May 12;97(18):1837-47
pubmed: 9603539
JACC Cardiovasc Imaging. 2009 Nov;2(11):1262-70
pubmed: 19909929
Interv Cardiol. 2017 Sep;12(2):97-109
pubmed: 29588737
J Thorac Dis. 2016 Jul;8(7):1688-96
pubmed: 27499958
Eur J Cardiovasc Nurs. 2011 Jul;10 Suppl 2:S5-13
pubmed: 21762852
Heart Fail Clin. 2016 Jan;12(1):1-10
pubmed: 26567971
PLoS One. 2016 May 05;11(5):e0154852
pubmed: 27149622
Atherosclerosis. 2009 Oct;206(2):451-7
pubmed: 19524922
Atherosclerosis. 2010 May;210(1):150-4
pubmed: 20031133
Eur Radiol. 2014 Jan;24(1):3-11
pubmed: 23887663
Am Heart J. 2004 Jul;148(1):7-15
pubmed: 15215786
J Diabetes Res. 2016;2016:4365156
pubmed: 27579325
J Am Coll Cardiol. 2009 May 5;53(18):1642-50
pubmed: 19406338
Vasc Health Risk Manag. 2010 May 25;6:307-16
pubmed: 20531948
JAMA. 2001 Jul 11;286(2):180-7
pubmed: 11448281
Atherosclerosis. 2007 Jul;193(1):11-9
pubmed: 16965775