Clinical utility of coronary computed tomography angiography in patients diagnosed with high-grade stenosis of the coronary arteries.
Coron Artery Dis
; 30(7): 511-519, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-30985482
ABSTRACT
OBJECTIVES:
We purposed to evaluate the reliability of coronary computed tomography angiography (CCTA) in patients with a CCTA finding of high-grade stenosis. PATIENTS ANDMETHODS:
Between May 2015 and March 2017, patients who underwent invasive coronary angiography (ICA) because of detection of high-grade stenosis by CCTA ( ≥ 70% stenosis of epicardial arteries or ≥ 50% of the left main coronary artery; Coronary Artery Disease Reporting and Data System grade 4 or 5) were selected for this study from our prospective registry cohort.RESULTS:
Among 646 eligible patients, only 263 (41%) patients were correctly diagnosed with significant coronary artery disease on ICA as same as CCTA findings. The per-vessel analysis revealed that 620 (68%) of 916 affected vessels had confirmed concordant significant stenosis between the CCTA and ICA results. The concordance rate was 49% among the segments with identified plaques in the per-segment analysis. Revascularization of the target vessel identified with severe stenosis by CCTA was performed in 228 (35%) patients. A logistic regression analysis revealed that smoking [odds ratio (OR) 1.59, 95% confidence interval (CI) 1.04-2.42, P = 0.03], taller height (OR 1.02, 95% CI 1.00-1.05, P = 0.016), and presence of typical symptoms of angina (OR 1.86, 95% CI 1.34-2.59, P < 0.001) were found to increase the probability of diagnostic concordance. A greater calcified segment involvement score (OR 0.88, 95% CI 0.82-0.94, P < 0.001) was associated with a lower diagnostic concordance.CONCLUSION:
The diagnostic discordance between CCTA and ICA was frequently observed in patients who were diagnosed with a CCTA finding of high-grade stenosis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Angiografia Coronária
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Estenose Coronária
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Tomografia Computadorizada Multidetectores
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Angiografia por Tomografia Computadorizada
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article