Coronary computed tomography angiography is effective for evaluating the risk of heart attacks and other adverse cardiac events in patients with suspected coronary artery disease, even if they don't have treatable risk factors.
While the treatment for heart disease often involves addressing modifiable risk factors like high cholesterol, diabetes or high blood pressure, researchers led by Jonathon Leipsic, M.D., of the University of British Columbia, were interested in developing a risk model for patients with suspected heart disease who don't have these cardiac risk factors.
"This scenario, where patients are symptomatic but have no cardiac risk factors, comes up often in clinical practice," Leipsic said in an announcement. "We lack a good tool to stratify these patients into risk groups."
In a study published online in the journal Radiology, Leipsic and colleagues correlated CCTA findings in 5,262 patients with suspected coronary heart disease but no modifiable risk factors. With an average follow-up period of 2.3 years, the researchers identified 104 patients who had adverse cardiac events.
More than one-quarter of these patients had non-obstructive disease or disease related to the buildup of plaque in the arteries, while another 12 percent had obstructive disease with a greater than 50 percent narrowing in a coronary artery "We found that patients with narrowing of the coronary arteries on CT had a much higher risk of an adverse cardiac event," Leipsic said. "This was true even for those without a family history of heart disease."
Leipsic said the findings demonstrate that clinicians need to revise the way they evaluate symptomatic patients who have no medically modifiable risk factors. "Doctors often dismiss [these patients] or do a treadmill test, which won't identify atherosclerosis and only has a modest sensitivity for detecting obstructive disease," he said, adding that CTA angiography could help address these patients.
The researchers rounded up the data from a confirmed registry of roughly 35,000 men and women who ranged in age, ethnicity and risk factors for CAD and CCTA evaluation, according to DOTmed News.
In 2009, researchers determined that using CCTA on ED patients presenting with chest pain reduced diagnosis times, as well as the cost of care.