MONDAY, Dec. 13 (HealthDay News) -- Adverse cardiovascular events among patients with normal findings on cardiac computed tomography angiography (CCTA) are uncommon, with the increasing burden of coronary artery disease (CAD) on CCTA associated with a higher rate of revascularization, myocardial infarction (MI), and death, according to a study published online Dec. 8 in the Journal of the American College of Cardiology.
In a systematic review and meta-analysis, Edward A. Hulten, M.D., M.P.H., of the Walter Reed Army Medical Center in Washington, D.C., and colleagues searched multiple databases for longitudinal studies of CCTA with at least three months' follow-up of symptomatic patients with suspected CAD reporting major adverse cardiovascular events (MACE), consisting of death, MI, and revascularization. They included 18 studies evaluating 9,592 patients with a median follow-up of 20 months.
The investigators found that the pooled annualized event rates for obstructive versus normal CCTA were 8.8 versus 0.17 percent per year for MACE and 3.2 versus 0.15 percent for death or MI. The investigators also found that the pooled negative likelihood ratio for MACE after normal CCTA findings was 0.008 and the positive likelihood ratio was 1.70, with a sensitivity of 0.99 and a specificity of 0.41. After stratifying by no CAD, nonobstructive CAD, or obstructive CAD, they found incrementally increasing adverse events.
"Adverse cardiovascular events among patients with normal CCTA findings are very rare and comparable to a baseline risk among healthy patients. Increasing burden of CAD on CCTA is associated with an increasing rate of revascularization, MI, and death," the authors write.
One author disclosed receiving moderate speaker honoraria from Novartis Pharmaceuticals.
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