NON-INVASIVE CORONARY ARTERIES ATHEROSCLEROSIS CT-VISUALIZATION: UP-TO-DATE STANDARDS AND OWN CLINICAL EXPERIENCE...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Diagnostic Cardiology

Background:

• Non-invasive coronary artery visualization is advancing, with a need for accurate methods to detect high-risk atherosclerotic plaques.
• Coronary artery disease (CAD) diagnosis and management require reliable tools for assessing plaque burden and guiding therapeutic interventions.
• Limited studies in Ukraine have evaluated the accuracy of advanced 640-sliced CTCA for diagnosing various forms of CAD.

Purpose of the Study:

• To evaluate the diagnostic accuracy of 640-sliced CTCA compared to invasive coronary angiography (iCAG).
• To assess CTCA's effectiveness in diagnosing different forms of chronic CAD before revascularization procedures.
• To determine the reliability of CTCA in quantifying atherosclerotic plaque burden and assessing lesion significance.

Main Methods:

• Prospective study of 201 patients with chronic CAD from January 2019 to May 2021.
• All patients underwent both planned CTCA and iCAG prior to revascularization (CABG or PCI).
• Analysis of 2412 visualized coronary segments, correlating coronary calcium index (CI) with atherosclerotic burden.

Main Results:

• CTCA demonstrated no false-negative results and only 6 (2.99%) false-positive results for insignificant lesions.
• High correlation between coronary calcium index and atherosclerotic burden (r=0.73, p<0.0001).
• CTCA showed high accuracy for significant stenoses (r=0.95, p<0.0001) and excellent prognostic accuracy (AUC 0.99, OR >>1000, p<0.0001).

Conclusions:

• High-multi-sliced CTCA is a safe and highly accurate method for qualitative and quantitative diagnosis of atherosclerotic coronary artery lesions.
• CTCA's diagnostic accuracy is comparable to iCAG, including the evaluation of hemodynamic significance.
• CTCA provides valuable insights into atherosclerosis pathophysiology and serves as a reliable indicator for therapeutic interventions in CAD patients.