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Diagnostic performance of computed tomographic coronary angiography in patients with end-stage renal disease

Borut Jug1, Jenny Papazian, Mohit Gupta

  • 1Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California 90502, USA. borut.jug@gmail.com

Coronary Artery Disease
|February 1, 2013
PubMed

Insights

Coronary computed tomographic angiography (CCTA) accurately detects coronary artery stenosis in patients with end-stage renal disease (ESRD). This diagnostic tool is valuable for pre-transplant cardiovascular screening in ESRD patients.

Area of Science:

  • Cardiology
  • Radiology
  • Nephrology

Background:

  • End-stage renal disease (ESRD) patients face a high risk of cardiovascular events, necessitating coronary atherosclerosis screening before kidney transplantation.
  • 64-slice multidetector coronary computed tomographic angiography (CCTA) was evaluated for its diagnostic performance in ESRD patients.

Purpose of the Study:

  • To assess the diagnostic accuracy of CCTA in detecting coronary artery stenosis in patients with ESRD.
  • To compare CCTA performance in ESRD patients versus non-ESRD individuals.

Main Methods:

  • Patients referred for CCTA and invasive coronary angiography (the gold standard) within six months were included.
  • Data were collected from clinical work-ups at two urban medical centers and the ACCURACY trial.

Main Results:

  • Thirty-one ESRD patients and 588 non-ESRD controls underwent CCTA and invasive coronary angiography.
  • CCTA demonstrated high sensitivity (100%) and specificity (78-91%) for detecting significant stenosis (≥50% or ≥70%) in ESRD patients.
  • No significant differences in diagnostic performance were observed between ESRD and non-ESRD groups.

Conclusions:

  • 64-row multidetector CCTA is highly sensitive and specific for detecting coronary artery stenosis, regardless of ESRD status.
  • CCTA is a promising tool for timely detection or exclusion of coronary atherosclerosis in pre-transplant cardiovascular surveillance for ESRD patients.
Abstract

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