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Age-Related Distribution and Severity of Coronary Artery Stenosis Assessed by 640-Row Coronary Computed Tomography
Dinh Nguyen1, Son P Duong2, Trieu V Tran3
1Cardiology, Hoa Hao Can Tho Medic General Hospital, Can Tho, VNM.
Insights
Significant coronary stenosis is common in patients with suspected coronary artery disease (CAD) undergoing 640-row coronary computed tomography angiography (CCTA). Older age is strongly linked to stenosis, with older men showing more extensive disease, and myocardial bridging is more frequent in men.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Interventional Cardiology
Background:
- Coronary computed tomography angiography (CCTA) is a key noninvasive tool for diagnosing coronary artery disease (CAD).
- Limited data exist on coronary stenosis patterns and disease extent using modern 640-row CCTA technology.
Purpose of the Study:
- To describe the pattern and extent of coronary stenosis in patients evaluated for CAD using 640-row CCTA.
- To investigate the association of significant stenosis with patient demographics, including age and sex.
Main Methods:
- A single-center, cross-sectional study included 390 patients with suspected CAD undergoing 640-row CCTA.
- Stenosis severity was assessed, defining significant stenosis as ≥50% in the left main or ≥70% in other major coronary arteries.
- Disease extent was categorized into single-vessel, two-vessel, or left main/three-vessel disease.
Main Results:
- Significant stenosis (≥50% or ≥70% narrowing) was found in 30.8% of patients.
- Older age (>60 years) was significantly associated with higher proportions of significant stenosis across major coronary arteries.
- Myocardial bridging occurred in 29.5% of patients, being more common in men.
Conclusions:
- Significant coronary stenosis is prevalent in patients undergoing 640-row CCTA for suspected CAD, particularly in older individuals.
- Older men with significant CAD showed more extensive disease; myocardial bridging was more frequent in men.
- 640-row CCTA effectively characterizes coronary stenosis patterns in clinical practice.
Background:
Coronary computed tomography angiography (CCTA) is an established noninvasive imaging modality for evaluating suspected coronary artery disease (CAD). However, data describing the pattern of coronary stenosis and the extent of significant disease in patients undergoing modern 640-row CCTA remain limited.
Methods:
This single-center cross-sectional study included 390 consecutive patients with suspected CAD who underwent 640-row CCTA between May 2021 and May 2022. Stenosis severity was assessed according to the coronary segment and major vessel involvement. Clinically significant stenosis was defined as luminal narrowing of ≥50% in the left main coronary artery (LM) or ≥70% in the left anterior descending, right coronary, or left circumflex arteries. The extent of significant CAD was categorized as single-vessel disease, two-vessel disease, or left main/three-vessel disease.
Results:
The mean age of the study population was 58.4±10.4 years, and 209 patients (53.6%) were men. Women were older than men (61.4±10.3 vs. 55.8±10.1 years, p<0.001). Myocardial bridging was identified in 115 patients (29.5%) and was more common in men than in women (73/209 (34.9%) vs. 42/181 (23.2%), p=0.011). Across all coronary segments, most lesions were classified as none-to-moderate stenosis, whereas severe stenosis and total occlusion were less frequent. CCTA-detected significant stenosis was observed in 120 patients (30.8%), while 270 patients (69.2%) had non-significant stenosis. Single-vessel disease, two-vessel disease, and left main or three-vessel disease were present in 46 (11.8%), 41 (10.5%), and 33 patients (8.5%), respectively. Patients older than 60 years had significantly higher proportions of significant stenosis in the left main artery, left anterior descending artery (LAD), right coronary artery (RCA), and left circumflex artery (LCx) (all p<0.001). Among patients with significant CAD, the extent of disease differed by sex in the older age group but not in the younger age group.
Conclusions:
In patients undergoing 640-row CCTA for suspected CAD, significant coronary stenosis was common and strongly associated with older age. Older men with significant CAD were more likely to have extensive disease, while myocardial bridging was more frequent and common in men. These findings highlight the clinical value of 640-row CCTA in the detailed characterization of coronary stenosis patterns in routine clinical practice.
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