Prognostic value of coronary computed tomography angiography in patients with prior percutaneous coronary intervention

Objective — We sought to determine the prognostic value of coronary computed tomography angiography (CCTA) in patients with a history of percutaneous coronary intervention (PCI).

Background — Although the prognostic value of CCTA has been well studied, its incremental value in patients with previous PCI has not been robustly investigated.

Methods — Consecutive patients with previous PCI were prospectively enrolled and CCTA images were evaluated for coronary artery disease (CAD) severity. Patients were followed for major adverse cardiovascular events (MACE) which was a composite of cardiac death and non-fatal myocardial infarction. All-cause death was assessed as a secondary endpoint.

Results — A total of 501 patients were analyzed with a mean follow-up time of 59.5 ± 32.0 months and 52 patients (10.4%) experienced MACE. Multivariable Cox regression analysis showed that CAD severity was a predictor of MACE with 0, 1, 2, and 3 vessel disease having annual rates of 1.3%, 2.2%, 2.2%, and 5.3%, respectively. All-cause death was similar in all categories of CAD.

Conclusions — In patients with previous PCI, CAD severity as measured with CCTA has independent and incremental prognostic value.