1. Prognostic Value of Stress Dynamic Myocardial Perfusion CT in a Multicenter Population With Known or Suspected Coronary Artery Disease
- Author
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Julian L. Wichmann, Sabrina Segreto, Yining Wang, U. Joseph Schoepf, Ullrich Ebersberger, Felix G. Meinel, Carlo N. De Cecco, Gladys G. Lo, Yeon Hyeon Choe, Francesca Pugliese, Fabian Bamberg, Meinel, Felix G., Pugliese, Francesca, Schoepf, U. Joseph, Ebersberger, Ullrich, Wichmann, Julian L., Lo, Gladys G., Choe, Yeon Hyeon, Wang, Yining, Segreto, Sabrina, Bamberg, Fabian, and De Cecco, Carlo N. more...
- Subjects
Male ,Computed Tomography Angiography ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,Prevalence ,Computed tomography angiography ,education.field_of_study ,medicine.diagnostic_test ,Incidence ,Myocardial Perfusion Imaging ,General Medicine ,Middle Aged ,Prognosis ,Europe ,Survival Rate ,Major adverse cardiac event ,Cardiology ,Female ,Radiology ,Perfusion ,CT ,Human ,medicine.medical_specialty ,Asia ,Prognosi ,Population ,Predictive value ,Reproducibility of Result ,Sensitivity and Specificity ,03 medical and health sciences ,Myocardial perfusion imaging ,Internal medicine ,Cox proportional hazards regression ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,education ,Survival rate ,Aged ,business.industry ,Risk Factor ,Reproducibility of Results ,medicine.disease ,Death, Sudden, Cardiac ,North America ,Exercise Test ,business ,Mace - Abstract
The purpose of this study was to determine the prognostic value of myocardial perfusion CT for major adverse cardiac events (MACE).Data from six centers in Asia, Europe, and North America on 144 patients with known or suspected coronary artery disease who had undergone coronary CT angiography (CCTA) and dynamic myocardial perfusion CT with a dual-source CT system were analyzed. CCTA studies were acquired at rest. Dynamic myocardial perfusion CT was performed under vasodilator stress. CCTA data were evaluated for the presence of coronary artery stenosis (≥ 50% luminal narrowing) on a per-vessel basis. Myocardial perfusion CT data were qualitatively evaluated for perfusion defects in each vessel territory. Patient follow-up was performed 6, 12, and 18 months after imaging. The prognostic value of CT findings was assessed with Kaplan-Meier statistics and the multivariate Cox proportional hazards regression model.According to the CCTA findings, 62 of 144 patients (43.1%) had at least one 50% or greater stenosis. According to the myocardial perfusion CT findings, 51 patients (35.4%) had one or more perfusion defects. Patients with at least one perfusion defect at myocardial perfusion CT were at increased risk of MACE (hazard ratio, 2.50; 95% CI, 1.34-4.65; p = 0.0040). This association remained significant after adjustment for age, sex, and clinical risk factors (hazard ratio, 2.41; 95% CI, 1.28-4.51; p = 0.0064) and after further adjustment for CCTA findings (hazard ratio, 2.03; 95% CI, 1.04-3.97; p = 0.0390). The number of territories with perfusion defects was strongly predictive of MACE with adjusted hazard ratios of 1.41, 3.44, and 4.76 for one, two, and three affected territories.In assessment for future MACE, myocardial perfusion CT has incremental predictive value over clinical risk factors and detection of coronary artery stenosis with CCTA. more...
- Published
- 2017
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