Anatomical Criteria of Malignancy by Computed Tomography Angiography in Patients With Anomalous Coronary Arteries With an Interarterial Course

OBJECTIVES: We sought to determine the relation between major adverse cardiac events (MACE) and anatomical criteria assessed by coronary computed tomography angiography (CCTA) in patients with an anomalous coronary artery with an interarterial course (ACAIAC).

METHODS: We selected CCTA studies of patients with an ACAIAC from a database of 4,160 examinations and studied anatomical criteria according to the presence of prior MACE, defined as syncope, unstable angina, myocardial infarction and resuscitated sudden cardiac death.

RESULTS: There were 19 patients (18 males) with an ACAIAC during the study period (incidence 0.46 %). Seven patients with prior MACE were younger (26 years vs 59 years, p < 0.001), had a smaller minimal lumen area (3.6 mm(2) vs 9.0 mm(2), p = 0.001), a higher degree of area stenosis (57 % vs 24 %, p = 0.001), a longer interarterial course (14.7 vs 8.6 mm, p = 0.003) and a smaller proximal segment width (1.6 mm vs 2.5 mm, p = 0.02) compared with the 12 patients without prior MACE. All patients with MACE had the following concomitant anatomical characteristics: minimum lumen area ≤4 mm(2), an area stenosis ≥50 % and intra-arterial length >10 mm

CONCLUSIONS: Prior MACE is associated with specific anatomical CCTA characteristics among patients with ACAIAC. CCTA may therefore contribute to distinguish patients at risk of adverse events. 

PMID: 25304820

Posted in Computed Tomography and tagged , , , , .

One Comment

  1. Quite the question and proposition by the authors: CT angiography helps with risk stratification in patients with anomalous coronary artery. The findings are interesting, however still in a small number of patients. Clinical use? Will anyone use milimetric measurements to decide if the patient requires surgery or not? Will anyone EVER use milimetric measurements to decide if the patient requires surgery or not?

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