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ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease
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J Am Coll Cardiol, 2008; 51:1510, doi:10.1016/j.jacc.2007.12.037
© 2008 by the American College of Cardiology Foundation
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CORRESPONDENCE: LETTER TO THE EDITOR

Is Computed Tomographic Angiography Prognostic in Patients With Cardiac Symptoms?

Christopher J. Suhar, MD*, Todd M. Hitchcock, MD, Robert J. Russo, MD, PhD, FACC and Eric J. Topol, MD, FACC

* Scripps Clinic/Green Hospital, Division of Cardiovascular Diseases, 10666 North Torrey Pines Road, SW206, La Jolla, California 92037 (Email: suhar.christopher{at}scrippshealth.org).

In the September 18, 2007, issue of the Journal, Min et al. (1) reported the results of their registry analysis of 1,127 patients with cardiac symptoms undergoing 16-slice coronary computed tomographic angiography. Their results suggest that all-cause mortality may be predicted by the results of computed tomographic angiography and the use of a simplified coronary plaque scoring system. If replicated, this study will be viewed as an important contribution to the field of cardiology.

There is one major issue we would like to raise. A substantial number of patients had moderate to severe triple-vessel coronary artery disease. We assume most of these patients underwent revascularization that may well have affected their 15-month all-cause mortality and confounded interpretation of the data. This was also pointed out by the editorialist, John J. Mahmarian, MD (2). In a single-center, registry trial, the revascularization procedures and outcomes should be readily obtained and reported.


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  1. Min J, Shaw L, Devereux R, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality J Am Coll Cardiol 2007;50:1161-1170.[Abstract/Free Full Text]
  2. Mahmarian J. Computed tomography coronary angiography as an anatomic basis for risk stratification J Am Coll Cardiol 2007;50:1171-1173.[Free Full Text]

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James K. Min, Leslee J. Shaw, Richard B. Devereux, Peter M. Okin, Jonathan W. Weinsaft, Donald J. Russo, Nicholas J. Lippolis, Daniel S. Berman, and Tracy Q. Callister
J. Am. Coll. Cardiol. 2008 51: 1510-1511. [Full Text] [PDF]




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