Related Experiment Video
Updated: Mar 8, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Prognostic performance of coronary computed tomography angiography in asymptomatic individuals as compared to
Gabriel Cordeiro Camargo1, Thais Peclat2, Ana Carolina Souza2
1Casa de Saúde São José, Rua Macedo Sobrinho, 21 - Humaitá, Rio de Janeiro, 22271-080, RJ, Brazil; Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, R. Prof. Rodolpho Paulo Rocco, 255 - Cidade Universitária, Rio de Janeiro, 21941-913, RJ, Brazil.
Insights
Coronary computed tomography angiography (CTA) in asymptomatic individuals identified high-risk patients effectively. This study found CTA provided valuable prognostic information in selected asymptomatic patients, comparable to symptomatic individuals.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Current guidelines exclude coronary computed tomography angiography (CTA) for asymptomatic individuals.
- This study compares the prognostic value of coronary CTA in asymptomatic versus symptomatic patients with appropriate indications.
Purpose of the Study:
- To evaluate the prognostic utility of coronary CTA in asymptomatic individuals.
- To compare the yield of coronary CTA in asymptomatic versus symptomatic patients.
Main Methods:
- 1080 patients underwent coronary CTA, divided into asymptomatic (n=674) and symptomatic (n=406) groups.
- Segment Stenosis Score (SSS) was calculated; patients were followed for a composite endpoint (all-cause death, MI, late revascularization).
- Multivariable analysis adjusted for CAD risk factors and symptoms.
Main Results:
- Higher SSS (>4) was observed in asymptomatic patients (27%) compared to symptomatic (20%).
- A high-risk CTA study and past smoking were independent predictors of adverse events after adjusting for confounders.
- The composite endpoint occurred in 49 patients over a mean follow-up of 4.4 years.
Conclusions:
- Coronary CTA in selected asymptomatic individuals yielded a higher rate of high-risk identification than in appropriately indicated symptomatic patients.
- Coronary CTA provides significant prognostic information in asymptomatic individuals, despite current guideline exclusions.
Introduction:
Current Appropriatene Usa Criteria exclude coronary computed tomography angiography (CTA) in asymptomatic individuals. We compared the prognostic value of coronary CTA in asymptomatic individuals to symptomatic patients with "definitely appropriate" indications for coronary CTA.
Methods:
Consecutive patients without previously known CAD referred for a CTA exam were divided into 2 groups. One group consisted ofasymptomatic individuals, the other of symptomatic patients with a "definitely appropriate" indication for coronary CT (unable to exercise and/or with an uninterpretable electrocardiogram and at an intermediate pre-test probability of obstructive coronary artery disease). Patients that did not fit into either groups were excluded. The segment stenosis score (SSS) was calculated based on coronary CTA and patients were followed for a composite endpoint of all-cause death, acute myocardial infarction and late revascularization.
Results:
A total of 1080 patients (60 ± 12 years, 65% male) were included in the study (674 "asymptomatic" and 406 "appropriate"). SSS >4 was more frequent in "asymptomatic" than in "appropriate" CT data sets (27% vs 20%, p = 0.02). After a mean follow-up of 4.4 ± 1.8 yrs, 49 patients reached the composite endpoint. On multivariable analysis adjusting for CAD risk factors and symptoms, only a high-risk CTA study and past smoking were independently predictive of events.
Conclusions:
Although currently not regarded as "definitely appropriate", the use of coronary CTA in a selected asymptomatic population had higher yield for identifying high-risk individuals than appropriately indicated studies in symptomatic patients and provided thequal prognostic information.
More Related Videos
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:29Angina III: Clinical Manifestations and Assessment
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...