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DIFFERENTIAL PROGNOSTIC VALUE OF CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN RELATION TO EXERCISE ELECTROCARDIOGRAPHY IN ASYMPTOMATIC SUBJECTS.
- Source :
-
Journal of Cardiovascular Ultrasound . Dec2015, Vol. 23 Issue 4, p244-252. 9p. - Publication Year :
- 2015
-
Abstract
- BACKGROUND: To explore the prognostic performance of coronary computed tomography angiography (CCTA) and exercise electrocardiography (XECG) in asymptomatic subjects. METHODS: We retrospectively enrolled 812 (59 ± 9 years, 60.8% male) asymptomatic subjects who underwent CCTA and XECG concurrently from 2003 through 2009- Subjects were followed-up for major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, unstable angina, and revascularization after 90 days from index CCTA. RESULTS: The prevalence of occult coronary artery disease (CAD) detected by CCTA was 17.5% and 120 subjects (14.8%) had positive XECG. During a mean follow-up of 37 ± 16 months, nine subjects experienced MACE. In multivariable Cox-regression analysis, only the presence of CAD by CCTA independently predicted future MACE (p = 0.002). Moreover, CAD by CCTA improved the predictive value when added to a clinical risk factor model using the likelihood ratio test (p < 0.001). Notably, the prognostic value of CCTA persisted in the moderate-to-high-risk group as classified by the Duke treadmill score (p = 0.040), but not in the low-risk group (p = 0.991). CONCLUSION: CCTA provides incremental prognostic benefit over and above XECG in an asymptomatic population, especially for those in a moderate-to-high-risk group as classified by the Duke treadmill score. Risk stratification using XECG may prove valuable for identifying asymptomatic subjects who can benefit from CCTA. [ABSTRACT FROM AUTHOR]
- Subjects :
- *COMPUTED tomography
*ELECTROCARDIOGRAPHY
*ANGIOGRAPHY
Subjects
Details
- Language :
- English
- ISSN :
- 19754612
- Volume :
- 23
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiovascular Ultrasound
- Publication Type :
- Academic Journal
- Accession number :
- 112725550
- Full Text :
- https://doi.org/10.4250/JCU.2015.23.4.244