Coronary artery diseaseRelation of Plaque Characteristics Defined by Coronary Computed Tomographic Angiography to ST-Segment Depression and Impaired Functional Capacity During Exercise Treadmill Testing in Patients Suspected of Having Coronary Heart Disease
Section snippets
Methods
Consecutive patients who underwent clinically indicated CCTA and ETT from July 2005 to May 2007 were identified retrospectively. Patients with previous known CAD, unstable angina pectoris, cardiomyopathy, or congenital heart disease were excluded from analysis. Demographic and clinical data were prospectively obtained at the time of ETT by a nurse using a standardized questionnaire. This study was conducted with the approval of the institutional review board at Weill Medical College of Cornell
Results
One hundred fifty-nine patients without preexisting cardiac disease and with interpretable baseline electrocardiograms underwent ETT and CCTA. One patient was excluded for nondiagnostic results on CCTA, and 2 were excluded for life-threatening noncardiac findings on CCTA. The remaining 156 patients were middle aged, with an intermediate prevalence of traditional cardiac risk factors (mean age 56.7 ± 12.2 years, 44% women; Table 1) and a low to intermediate prevalence of abnormalities on ETT or
Discussion
To our knowledge, these data represent the first to relate plaque characteristics on CCTA to functional myocardial ischemia, exercise capacity, and the DTS on ETT in a low- to intermediate-risk population. In our cohort, plaque severity, location, and composition on CCTA were significant predictors of exercise-induced STD. The association of STD with CCTA-identified obstructive CAD in the present study is consistent with past evidence relating STD to the anatomic and functional extent of
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