Journal article
Prognostic Performance of Prospective versus Retrospective Electrocardiographic Gating in Coronary Computed Tomographic Angiography
Texas Heart Institute journal, Vol.45(4), pp.214-220
08/01/2018
DOI: 10.14503/THIJ-17-6270
PMCID: PMC6183632
PMID: 30374228
Abstract
Coronary computed tomographic angiography (CCTA) with prospective electrocardio-graphic gating reduces radiation exposure, but its prognostic power for predicting cardiovascular risk in patients with suspected CAD has not been fully validated. To determine whether prospective gating performs as well as retrospective gating in this population, we compared these scan modes in patients undergoing 64-slice CCTA.
From January 2009 through September 2011, 1,407 patients underwent CCTA; of these, 915 (mean age, 57.8 +/- 13.5 yr; 54% male) had suspected coronary artery disease at the time of CCTA and were included in the study. Prospective gating was used in 195 (21%) and retrospective gating in 720 (79%). The mean follow-up duration was 2.4 +/- 0.9 years.
Overall, 390 patients (42.6%) had normal results on CCTA, 382 (41.7%) had nonobstructive coronary artery disease, and 143 (15.6%) had obstructive disease. Major adverse cardiac events occurred in 32 patients (3.5%): 11 cardiac deaths, 15 late revascularizations, and 6 nonfatal myocardial infarctions. Total event occurrences were similar in both groups (retrospective, 3.8%; prospective, 2.6%; P = 0.42), as were the occurrences of each type of event. On adjusted multivariate analysis, nonobstructive (P = 0.015) and obstructive (P < 0.001) coronary artery disease were independently associated with major adverse cardiac events. Scan mode was not a predictor of outcome. The mean effective radiation dose was 4 +/- 2 mSv for prospective compared with 12 +/- 4 mSv for retrospective gating (P < 0.01).
The prognostic value of CCTA with prospective electrocardiographic gating compares favorably with that of retrospective gating, and it involves significantly less radiation exposure.
Details
- Title: Subtitle
- Prognostic Performance of Prospective versus Retrospective Electrocardiographic Gating in Coronary Computed Tomographic Angiography
- Creators
- Pradnya Velankar - Houston MethodistKongkiat Chaikriangkrai - Houston MethodistNinad Dewal - Baylor College of MedicineSayf Khaleel Bala - Houston MethodistBelqis Elferjani - Houston MethodistSama Alchalabi - Houston MethodistSu Min Chang - Academic Institute
- Resource Type
- Journal article
- Publication Details
- Texas Heart Institute journal, Vol.45(4), pp.214-220
- Publisher
- Texas Heart Inst
- DOI
- 10.14503/THIJ-17-6270
- PMID
- 30374228
- PMCID
- PMC6183632
- ISSN
- 1526-6702
- eISSN
- 1526-6702
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2018
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359825002771
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