Open AccessPrognostic Impact of Nonobstructive Coronary Artery Disease Detected by Coronary Computed Tomographic Angiography
Author(s) -
Daniel Košuta,
Borut Jug,
Zlatko Fras
Publication year - 2021
Publication title -
angiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.74
H-Index - 65
eISSN - 1940-1574
pISSN - 0003-3197
DOI - 10.1177/0003319721999494
Subject(s) - medicine , coronary artery disease , cardiology , cad , myocardial infarction , revascularization , chest pain , computed tomographic angiography , stenosis , unstable angina , incidence (geometry) , radiology , angiography , physics , optics , engineering drawing , engineering
Coronary computed tomographic angiography (CCTA) is a promising technique for ruling out coronary artery disease (CAD) in patients with chest pain. We aimed to investigate the prognostic impact of nonobstructive CAD on CCTA. We retrospectively reviewed patients who underwent CCTA between 2010 and 2016 at our institution. We divided them into 3 groups: (1) patients with no CAD, (2) patients with nonobstructive CAD, and (3) patients with obstructive CAD. We investigated the incidence of the primary outcome (combination of death, nonfatal myocardial infarction, unstable angina, and late revascularization). A total of 989 patients were included: 540 patients had CAD, which was obstructive (≥50% stenosis) in 256 cases. During the follow-up period, 99 events occurred (32 [7%] in patients without CAD, 26 [9%] in patients with nonobstructive CAD, and 41 [16%] in patients with obstructive CAD; P < .001). The presence of nonobstructive and obstructive CAD was an independent predictor of events (HR: 2.33 [1.15-4.69], P < .001; and 4.02 [1.98-8.13], P = .019, respectively) compared with no CAD. Nonobstructive CAD on CCTA is associated with a 2-fold increase in risk of coronary events compared with patients with no CAD.