Prognostic value of dual-source multidetector computed tomography coronary angiography in patients with stent implantation

Int J Cardiovasc Imaging. 2013 Oct;29(7):1603-11. doi: 10.1007/s10554-013-0236-4. Epub 2013 May 12.

Abstract

We aim to evaluate the prognostic value of dual-source 64-slice multidetector computed tomography (MDCT) in patients with coronary stents. The study included 173 patients [mean age 59.9 ± 10.1 years, 76.7 % male] with previous stent implantation who underwent MDCT for evaluation of CAD and stent patency. Coronary imaging was performed via dual-source MDCT scanner. Stented vessel segment was evaluated as patent without neointimal hyperplasia (NIH), nonobstructive NIH (<50 % luminal narrowing), or obstructive NIH (>50 % luminal narrowing). Patients were evaluated for major cardiovascular events (MACEs) to demonstrate association between stent patency and clinical outcome. MACEs that were originating from non-stented segments were excluded. A total of 213 coronary stents were evaluated in our study. During mean of 21.2 ± 13.6 months' follow-up, 25 patients experienced MACEs [1 (4.0 %) cardiac death, 5 (20.0 %) nonfatal MI, and 19 (76.0 %) unstable angina pectoris requiring hospitalization and target vessel revascularization] associated with stented segment of coronary arteries. One hundred of 105 patients (95.2 %) with a patent stent without NIH detected by MDCT had no cardiac event associated with stented segments during mean 2 years' follow-up period. These data indicate that patients with a patent stent without NIH as determined by MDCT have a good prognosis as opposed to an increased rate of events among patients with either nonobstructive or obstructive NIH as determined with MDCT, supporting MDCT as a reliable tool to evaluate patients after coronary stenting.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Angina, Unstable / diagnostic imaging*
  • Angina, Unstable / etiology
  • Angina, Unstable / mortality
  • Angina, Unstable / physiopathology
  • Angina, Unstable / therapy
  • Coronary Angiography / methods*
  • Coronary Restenosis / diagnostic imaging*
  • Coronary Restenosis / etiology
  • Coronary Restenosis / mortality
  • Coronary Restenosis / physiopathology
  • Coronary Restenosis / therapy
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiopathology
  • Disease-Free Survival
  • Female
  • Humans
  • Hyperplasia
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Myocardial Infarction / diagnostic imaging*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy
  • Neointima
  • Patient Readmission
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / mortality
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency