CT Angiography Identifies Risk of Mortality
A study in the current issue of the Journal of the American College of Cardiology details the benefits of scanning with multidetector coronary computed tomographic angiography (CCTA) for patients who present with chest symptoms.
A cohort of 1,127 patients over age 45 from the same institution who presented with chest symptoms (tightness, palpitations, dyspnea, or pain) underwent CCTA. The amount of stenosis captured with CCTA was ranked at one of four levels: minimal, mild, moderate, or severe. Three different means were used to grade plaque formation.
The team then evaluated the death rate in the cohort of patients. The average length of follow-up was 15.3 months.
A number of factors that predicted death were detected with CCTA: the number of vessels with stenosis greater than 50 percent, number of vessels with stenosis greater than 70 percent, and stenosis of the proximal left anterior descending artery. All of these factors, independently, were highly statistically significant.
The lowest risk of death was among patients with less then 50 percent stenosis. Survival was worse, overall, for patients with higher-risk Duke scores. In particular, the lowest survival rate was 85 percent among patients with stenosis to the left main artery. The burden and distribution of plaque also contributed to the absolute death rate.
CCTA can accurately identify a patient’s all-cause risk of mortality, according to the report completed by the team at Weill Medical College of Cornell. This is one of the first studies to validate the use of CCTA in this setting.
Other recent studies have validated the use of CTA for other purposes. Yesterday, a report was posted on Hospital Buyer describing use of the technique before repeat graft repair. CT Angiography has also been described as the superior modality in assessing the extent of peripheral artery disease.
September 27, 2007 Related topics: Imaging, Diagnostic, Radiology, Cardiology