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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Ruling out coronary artery disease with noninvasive coronary multidetector CT angiography before noncoronary

Paz Catalán1, Rubén Leta, Alberto Hidalgo

  • 1Cardiac Imaging Unit, Department of Cardiovascular Surgery and Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Clínica Creu Blanca, Reina Elisenda de Montcada 17, Barcelona 08034, Spain. pcatalan@creu-blanca.es

Radiology
|November 17, 2010
PubMed

Insights

Preoperative coronary computed tomographic angiography is useful for detecting coronary artery disease in patients undergoing noncoronary cardiovascular surgery. This imaging can safely avoid unnecessary invasive coronary angiography in many cases.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Cardiac Surgery

Background:

  • Coronary artery disease (CAD) assessment is crucial before noncoronary cardiovascular surgery.
  • Invasive coronary angiography (ICA) is the gold standard but carries risks.
  • Non-invasive imaging modalities are sought to optimize patient selection and reduce unnecessary procedures.

Purpose of the Study:

  • To evaluate the diagnostic utility of preoperative coronary computed tomographic (CT) angiography.
  • To determine its effectiveness in identifying coronary artery disease (CAD) in patients undergoing noncoronary cardiovascular surgery.
  • To assess its role in potentially avoiding invasive coronary angiography (ICA).

Main Methods:

  • Prospective study of 161 patients undergoing noncoronary cardiovascular surgery.
  • Coronary calcium scoring and coronary CT angiography were performed preoperatively.
  • Follow-up assessed ischemic events; multivariate analysis identified predictors of nondiagnostic CT angiography.

Main Results:

  • Coronary CT angiography was diagnostic in 81% of 133 patients (108/133).
  • 93% of patients with diagnostic CT angiography had no significant CAD and proceeded without ICA.
  • The Agatston coronary calcium score was the sole independent predictor of nondiagnostic CT angiography (cutoff 579).

Conclusions:

  • Preoperative coronary CT angiography is a valuable tool in nonselected patients undergoing noncoronary cardiovascular surgery.
  • It can safely identify patients who do not require invasive coronary angiography.
  • The Agatston score predicts the diagnostic quality of coronary CT angiography.
Abstract

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