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Negative coronary CT angiography for chest pain assessment predicts low event rate in 5 years
Author(s) -
Chong Fei Y,
Soon Kean,
Brown Fraser,
Bell Kevin,
Lim Yean L
Publication year - 2012
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2011.02332.x
Subject(s) - medicine , chest pain , myocardial infarction , cardiology , confidence interval , coronary artery disease , coronary arteries , radiology , artery
Coronary CT angiography (CTA) is becoming a popular investigation for chest pain. A negative coronary CTA is known to have a good negative predictive value for major adverse cardiovascular events in short term. The data on the long‐term outcomes of negative coronary CTA are lacking. We aim to investigate the long‐term prognostic value of negative coronary CTA in the evaluation of chest pain. Methods: This was a retrospective observational study involving 259 cases of coronary CTA on our registry from July 2004 to November 2006. All coronary CTA were performed with GE 16‐slice CT and then GE 64‐slice CT scanner in late 2006. A negative coronary CTA was defined as no single coronary segment with stenosis ≥50% based on American Heart Association 16‐segment model. The end point of the study was defined as a composite of major cardiovascular events such as myocardial infarction, myocardial death or revascularisation. Results: Seventy cases of 259 on the registry were diagnosed as negative studies. Mean follow‐up period was 4.64 ± 0.6 years (range from 3.4 to 5.7 years). Of these negative studies, only one patient suffered from the end point during the follow‐up. Thus, the negative predictive value of a negative coronary CTA for a long‐term major cardiovascular event was 0.986 (95% confidence interval: 0.92–0.99). Conclusions: A negative coronary CTA in patients with a low or intermediate pretest probability for significant coronary artery disease predicts a low rate of major cardiovascular events within a 5‐year period.