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RSNA - CT Angiography Helps Predict Heart Attack Risk
Date:2/19/2013

rtery disease but no medically modifiable risk factors. They culled the data from the Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter (CONFIRM) registry.

After an average follow-up of 2.3 years, 104 patients had experienced a major adverse cardiovascular event. The researchers identified a high prevalence of coronary artery disease in the study group, despite the absence of modifiable risk factors. More than one-quarter of the patients had non-obstructive disease or disease related to the buildup of plaque in the arteries, and another 12 percent had obstructive disease with a greater than 50 percent narrowing in a coronary artery.

“We found that patients with narrowing of the coronary arteries on CT had a much higher risk of an adverse cardiac event,” Dr. Leipsic said. “This was true even for those without a family history of heart disease.”

Both symptomatic and asymptomatic patients with obstructive disease faced an increased risk for a major cardiac event. In contrast, the absence of coronary artery disease on CCTA was associated with a very low risk of a major event.

The findings highlight the need for refinement in the evaluation of individuals who may be missed by traditional methods of coronary artery disease evaluation.

“If a patient shows up with vague symptoms and no medically modifiable risk factors, doctors often dismiss them or do a treadmill test, which won’t identify atherosclerosis and only has a modest sensitivity for detecting obstructive disease,” Dr. Leipsic said.

CCTA could help address this problem, Dr. Leipsic added, by helping to diagnose or rule out coronary artery disease and identifying those who may benefit from more intensive therapy.

The researchers continue to study the CONFIRM data with the aim to learn more about the relationship between plaque and heart attacks and the longer-term outlook for patients with coronary artery disease.

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