Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography

Research output: Contribution to journalArticle

Pradnya Velankar, Kongkiat Chaikriangkrai, Ninad Dewal, Sayf Khaleel Bala, Belqis Elferjani, Sama Alchalabi, Su-Min Chang

Coronary computed tomographic angiography (CCTA) with prospective electrocardiographic 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.

Original languageEnglish (US)
Pages (from-to)214-220
Number of pages7
JournalTexas Heart Institute Journal
Volume45
Issue number4
DOIs
StatePublished - Aug 1 2018

PMID: 30374228

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Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography. / Velankar, Pradnya; Chaikriangkrai, Kongkiat; Dewal, Ninad; Bala, Sayf Khaleel; Elferjani, Belqis; Alchalabi, Sama; Chang, Su-Min.

In: Texas Heart Institute Journal, Vol. 45, No. 4, 01.08.2018, p. 214-220.

Research output: Contribution to journalArticle

Harvard

Velankar, P, Chaikriangkrai, K, Dewal, N, Bala, SK, Elferjani, B, Alchalabi, S & Chang, S-M 2018, 'Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography' Texas Heart Institute Journal, vol. 45, no. 4, pp. 214-220. https://doi.org/10.14503/THIJ-17-6270

APA

Velankar, P., Chaikriangkrai, K., Dewal, N., Bala, S. K., Elferjani, B., Alchalabi, S., & Chang, S-M. (2018). Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography. Texas Heart Institute Journal, 45(4), 214-220. https://doi.org/10.14503/THIJ-17-6270

Vancouver

Velankar P, Chaikriangkrai K, Dewal N, Bala SK, Elferjani B, Alchalabi S et al. Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography. Texas Heart Institute Journal. 2018 Aug 1;45(4):214-220. https://doi.org/10.14503/THIJ-17-6270

Author

Velankar, Pradnya ; Chaikriangkrai, Kongkiat ; Dewal, Ninad ; Bala, Sayf Khaleel ; Elferjani, Belqis ; Alchalabi, Sama ; Chang, Su-Min. / Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography. In: Texas Heart Institute Journal. 2018 ; Vol. 45, No. 4. pp. 214-220.

BibTeX

@article{d2726b59035a4601a5193dbfeb5b10ee,
title = "Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography",
abstract = "Coronary computed tomographic angiography (CCTA) with prospective electrocardiographic 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.",
keywords = "Cardiac-gated imaging techniques, Coronary angiography/methods/ standards, Coronary artery disease/diagnostic imaging, Coronary vessels/pathology, Image processing, computer-assisted, Models, cardiovascular, Predictive value of tests, Radiation dosage, Retrospective studies, Tomography, X-ray computed/methods",
author = "Pradnya Velankar and Kongkiat Chaikriangkrai and Ninad Dewal and Bala, {Sayf Khaleel} and Belqis Elferjani and Sama Alchalabi and Su-Min Chang",
year = "2018",
month = "8",
day = "1",
doi = "10.14503/THIJ-17-6270",
language = "English (US)",
volume = "45",
pages = "214--220",
journal = "Texas Heart Institute Journal",
issn = "0730-2347",
publisher = "Texas Heart Institute",
number = "4",

}

RIS

TY - JOUR

T1 - Prognostic performance of prospective versus retrospective electrocardiographic gating in coronary computed tomographic angiography

AU - Velankar, Pradnya

AU - Chaikriangkrai, Kongkiat

AU - Dewal, Ninad

AU - Bala, Sayf Khaleel

AU - Elferjani, Belqis

AU - Alchalabi, Sama

AU - Chang, Su-Min

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Coronary computed tomographic angiography (CCTA) with prospective electrocardiographic 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.

AB - Coronary computed tomographic angiography (CCTA) with prospective electrocardiographic 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.

KW - Cardiac-gated imaging techniques

KW - Coronary angiography/methods/ standards

KW - Coronary artery disease/diagnostic imaging

KW - Coronary vessels/pathology

KW - Image processing, computer-assisted

KW - Models, cardiovascular

KW - Predictive value of tests

KW - Radiation dosage

KW - Retrospective studies

KW - Tomography

KW - X-ray computed/methods

UR - http://www.scopus.com/inward/record.url?scp=85055085918&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055085918&partnerID=8YFLogxK

U2 - 10.14503/THIJ-17-6270

DO - 10.14503/THIJ-17-6270

M3 - Article

VL - 45

SP - 214

EP - 220

JO - Texas Heart Institute Journal

T2 - Texas Heart Institute Journal

JF - Texas Heart Institute Journal

SN - 0730-2347

IS - 4

ER -

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