Cardiac CTA Has Strong Prognostic Value in Patients Without ACS

Objective: To evaluate the predictive value of cardiac CT angiography beyond coronary artery calcium (CAC) in patients who present with acute chest pain but are not found to have had acute coronary syndrome (ACS). Design: Retrospective study. Participants: 458 patients who had presented to the emergency department with acute chest pain and had undergone cardiac CT angiography (CTA). All patients who were diagnosed with ACS (unstable angina or myocardial infarction) during the index hospitalization were excluded, as were patients with clinically important noncardiac findings. Methods: The primary end point measured was the occurrence of a major adverse cardiac event (MACE). A MACE was considered cardiac death, nonfatal myocardial infarction, unstable angina, or revascularization. All patients' clinical risk factors were recorded. During the cardiac CTAs, noncontrast CAC scoring was performed followed by contrast-enhanced coronary CTA. An obstructive lesion was one that narrowed the co more...