scholarly journals Efficiency of Multislice Computed Tomography in Diagnosis of Coronary Artery Disease compared to Cardiac Catheterization

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Nagwan Elhussein ◽  
Rania Mohammed Ahmed ◽  
Rawan AL-Thobity ◽  
Hadeel Al-Qurashi ◽  
Shahad AL-Sulimani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Ct Scan ◽  
Cardiac Catheterization ◽  
Multislice Computed Tomography ◽  
Statistical Significance ◽  
Invasive Technique ◽  
Artery Disease

Coronary artery disease (CAD) is a leading cause of mortality and morbidity in developed countries, although percutaneous coronary intervention and coronary artery bypass grafting have developed recently, also multislice computed tomography has been accepted tool for diagnosing of (CAD). Objective: To assess the efficiency of multislice computed tomography in diagnosing coronary heart disease compared with cardiac catheterization. Method: This retrospective study was conducted at Alhada Military hospital in Taif City, Saudi Arabia, in radiology and cardiac catheterization departments during period from January to April 2018. The study was done by collecting of 51 patients reports of computed tomography and coronary artery catheterization most of them complain of chest pain. Data was analyzed using statistical package for social sciences program (SPSS) version 21.00. And achieved in tables and graphs in percentages according to the age, gender, patient history, symptoms, CT finding and catheterization finding, from the check list. Results: The most common affected age group was (61-80)y, male were (52.9%), the most complain was chest pain. CT scan positive findings were found to be in (72.5%) of the patients, while the cardiac catheterization diagnosed (CAD) in (68.6%) of the patients, there are statistical significance difference between the CT and cardiac catheterization finding (P=0.00), but there were no statistical significance difference between cardiac catheterization finding with age and gender among study sample. Conclusion: CT scan can accurately diagnose the coronary artery disease, which is an ideal non-invasive technique compared with cardiac catheterization.

scholarly journals 1173 Additional role of FFRct and stress CT perfusion in the management of patients with stable chest pain compared to cCTA alone

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Baggiano ◽  
M Guglielmo ◽  
G Muscogiuri ◽  
L Fusini ◽  
A Del Torto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Invasive Technique ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Non Invasive ◽  
Artery Disease ◽  
Stable Chest Pain

Abstract Background Computed tomography-derived fractional flow reserve (FFRCT) and stress computed tomography perfusion (stress-CTP) are new techniques that combine anatomy and functional evaluation to improve assessment of coronary artery disease (CAD) using coronary computed tomography angiography (cCTA). Purpose This study sought to determine the effect of adding FFRCT and stress-CTP to cCTA alone for assessment of lesion severity and patient management of patients referred for chest pain. Methods 289 patients with stable chest pain scheduled for clinically indicated invasive coronary angiography (ICA) plus invasive FFR were evaluated with cCTA, FFRCT, and stress-CTP. Of 289 patients, 147 underwent static stress-CTP, while 142 were evaluated with dynamic stress-CTP. Management plan with optimal medical therapy (OMT) or percutaneous coronary intervention (PCI) for each patient according to results of each non-invasive technique was recorded, and then compared to what effectively applied according to results of reference standard technique (ICA + FFR). The primary endpoints for the study were the correct allocation of patients to OMT or PCI using cCTA, cCTA + FFRCT and cCTA + stress-CTP, and the correct assessment of non-invasive techniques for all three vessels in relation to angiographically and FFR-defined significance. Results Compared to cCTA alone, the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to OMT from 24% to 38% and 44%, respectively, while the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to PCI from 29% to 32% and 36%, respectively. Using ICA + FFR as standard reference, cCTA showed agreement for all three vessels in 56% of patients, while combined approaches of cCTA + FFRCT and cCTA + stress-CTP showed agreement in 66% and 82% of patients, respectively. Conclusions The addition of functional assessment with FFRCT or Stress-CTP to cCTA has a substantial effect on the evaluation of the relevance of coronary artery disease and therefore on the management of patients compared to cCTA alone.

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

Cardiology ◽  
2015 ◽  
Vol 133 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Mathias Sørgaard ◽  
Jesper James Linde ◽  
Klaus Fuglsang Kofoed ◽  
Jørgen Tobias Kühl ◽  
Henning Kelbæk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Stress Test ◽  
Photon Emission ◽  
Acute Onset ◽  
Emission Computed Tomography ◽  
Artery Disease

Objectives: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. Methods: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We compared the diagnostic accuracy of PTP and stress testing assessed by the area under the receiver operating characteristic curve (AUC) to identify significant CAD, defined as at least 1 coronary artery branch with >70% diameter stenosis identified by CCTA. Results: The diagnostic accuracy of PTP was significantly higher than the stress test (AUC 0.80 vs. 0.69; p = 0.009), but the diagnostic accuracy of the combination of PTP and a stress test did not significantly increase when compared to PTP alone (AUC 0.86 vs. 0.80; p = 0.06). Conclusions: PTP using the updated Diamond and Forrester Score is a very useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.

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