Cited 6 times since 2017 (0.9 per year) source: EuropePMC JACC. Cardiovascular imaging, Volume 10, Issue 12, 17 3 2017, Pages 1451-1458 Long-Term Prognosis of Patients With Intramural Course of Coronary Arteries Assessed With CT Angiography. Dimitriu-Leen AC, van Rosendael AR, Smit JM, van Elst T, van Geloven N, Maaniitty T, Jukema JW, Delgado V, Scholte AJHA, Saraste A, Knuuti J, Bax JJ
Objectives
The aim of the present study was to evaluate, in low-to-intermediate pre-test probability patients who were referred for coronary computed tomography angiography (CTA) and did not show obstructive coronary artery disease (CAD), whether an intramural course of a coronary artery is associated with worse outcome compared with patients without an intramural course of the coronary arteries.
Background
The prognostic value of an intramural course of the coronary arteries on coronary CTA in patients without obstructive CAD is not well-known.
Methods
The study population consisted of 947 patients with a low-to-intermediate pre-test probability who were referred for coronary CTA and who did not have obstructive CAD. During follow-up, the occurrence of unstable angina pectoris that required hospitalization, nonfatal myocardial infarction, and all-cause mortality was evaluated.
Results
On coronary CTA, 210 patients (22%) had an intramural course of a coronary artery. The median depth of the intramural course was 1.9 mm (interquartile range: 1.4 to 2.6 mm). In 84 patients (40%), the depth of the intramural course was considered deep (>2 mm surrounded by myocardium). During a median follow-up of 4.9 years (interquartile range: 3.2 to 6.9 years), a total of 43 events occurred: hospitalization due to unstable angina pectoris in 13 patients (1.4%); 7 patients (0.7%) had a nonfatal myocardial infarction; and 23 patients died (2.4%). The 6-year cumulative event rate of unstable angina pectoris requiring hospitalization (0.0% vs. 1.1%), nonfatal myocardial infarction (0.5% vs. 0.4%), all-cause mortality (1.9% vs. 2.2%) as well as the combined endpoint of all 3 events (2.4% vs. 3.7%) was similar in patients with and without an intramural course of a coronary artery.
Conclusions
In patients without obstructive CAD on coronary CTA, the presence of an intramural course of a coronary artery was not associated with worse outcome.
