Normal coronary CT angiography with subsequent adverse cardiac events

Multi-detector row coronary computed tomography (CT) angiography is an emerging noninvasive diagnostic tool for coronary artery disease. Because of the high negative predictive value of the test, coronary CT angiography is useful for ruling out significant coronary artery stenosis in patients with chest pain. Between 2003 and 2009, 2,148 (50%) of 4,337 patients who underwent coronary CT angiography had a normal coronary artery. Of the 2,148 patients, only two (0.09%) experienced cardiovascular events within three months of their index visit. One patient underwent invasive coronary angiography based on a positive exercise test result, while the second underwent invasive coronary angiography due to an episode of chest pain. Coronary angiographic examination of these two patients revealed significant luminal narrowing of the proximal left anterior descending artery; both patients underwent revascularization at the discretion of their physician. (Korean J Med 79:553-558, 2010)