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Clinical utility of coronary computed tomography angiography in patients diagnosed with high-grade stenosis of the coronary arteries

Title
Clinical utility of coronary computed tomography angiography in patients diagnosed with high-grade stenosis of the coronary arteries
Authors
Kim C.Hong S.-J.Shin S.Ahn C.-M.Kim J.-S.Kim B.-K.Ko Y.-G.Choi B.-W.Choi D.Jang Y.Hong M.-K.
Ewha Authors
신상훈
Issue Date
2019
Journal Title
Coronary artery disease
ISSN
1473-5830JCR Link
Citation
Coronary artery disease vol. 30, no. 7, pp. 511 - 519
Publisher
NLM (Medline)
Indexed
SCIE; SCOPUS scopus
Document Type
Article
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 AND METHODS: 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.
DOI
10.1097/MCA.0000000000000750
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의료원 > 의료원 > Journal papers
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