Determining patient prognosis using computed tomography coronary angiography

Abstract

In addition to demonstrating luminal narrowings, cardiac computed tomography angiography (CTA) has the ability to detect nonstenotic plaque, vessel wall calcification and can assess left ventricular function. CTA prognostic studies have considered these components individually and in combination to produce novel risk factor scores to help predict clinical outcomes. In this article, we will consider the utility of CTA to predict clinical risk by considering the evidence for luminal stenosis, plaque scores, plaque descriptors and models combining these elements. We will also discuss some of the emerging applications of CTA that will likely provide future prognostic data in coronary artery disease patients. Although initially described as an anatomical investigation to determine the presence of coronary disease, CTA is being explored as a tool for functional imaging and may soon provide a noninvasive technique of anatomical and functional assessment previously only possible by invasive methods.

Keywords::

• computed tomography
• coronary artery calcification
• coronary artery disease
• coronary atherosclerosis
• CT coronary angiography
• major adverse cardiac events
• prognosis

Financial & competing interests disclosure

Benjamin Chow is supported by CIHR New Investigator Award #MSH-83718. Benjamin Chow receives research and fellowship training support from GE Healthcare, research support from Pfizer and AstraZeneca, and educational support from TeraRecon Inc. Gary Small is supported by the University of Ottawa Cardiology Research Endowment Fellowship Fund. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.