Background: In patients with known or suspected coronary artery disease (CAD), assessment of prognosis is essential in appropriate management. Recently, coronary multidetector computed tomographic angiography (CCTA) enables accurate assessment of coronary artery stenosis as well as evaluation of coronary plaque. Therefore, the purpose of this study was to determine the prognostic value of CCTA to predict adverse cardiac events in Korean population. Methods: We studied 2,080 patients (931 males, 61.4짹12.2 years) with known or suspected CAD undergoing 64-slice CCTA. The severity of CAD and plaque was classified into 1) nonobstructive (luminal narrowing <50%) and 2) obstructive (luminal narrowing ���50%). The extent of CAD and plaque was presented as the number of segments with plaques. Patients were followed up for the occurrence of: 1) cardiac death, 2) nonfatal myocardial infarction, 3) unstable angina requiring hospitalization, and 4) revascularization. The patients with experiencing early cardiac events within 30 days after CCTA were excluded from the analysis. Results: The 1,107 patients (53.2%) had CAD. During mean follow-up 12.6짹11.6 months, 76 patients (3.7%) had experienced cardiac events. All cardiac events were occurred in patients with CAD. Among the patients with cardiac events, 63 patients (82.9%) had obstructive CAD and 13 patients (17.1%) had nonobstructive CAD. In multivariate Cox analysis,independent predictors of cardiac events were obstructive CAD (HR 3.59, p=0.001) and number of segments with plaques (HR 1.15, p<0.05). The patients with more than 3 segments with plaques had higher risk for cardiac events (9.8% vs. 2.9% in 1 or 2 segments of plaques. Especially, in nonobstructive CAD, the number of segments with coronary plaques was independent predictor of cardiac events. Conclusions: In our study, the presence of obstructive CAD and number of segments with coronary plaques on CCTA were significant predictors of adverse cardiac events. CCTA might predict cardiac events in Korean patients with known or suspected CAD.