Author + information
- Makoto Kondo,
- Takeshi Kondo,
- Fujimoto Shinichiro,
- Kazuhisa Takamura,
- Hiroshi Arai,
- Tadaaki Orihara,
- Junichi Sugiyama,
- Akira Endo,
- Hiroshi Fukazawa,
- Hideki Nagaoka and
- Akitsugu Oida
Diabetes Mellitus (DM) was defined as high risk in ATP-III 10 year risk, and asymptomatic patients with high risk find uncertain indication for both CT angiography (CTA) and non-contrast CT for coronary calcium score (CACS) in the Cardiac CT 2010 Appropriate Use Criteria. The purpose was to evaluate the relevance of CACS and CTA in asymptomatic patients with DM.
Coronary CTA was performed using 320-MDCT in 5453 consecutive patients for suspected coronary artery disease. Of those, after excluding patients with motion artifacts, remaining 282 asymptomatic subjects (M/F=203/79, 66±10y) with DM and “Non” category of Duke Clinical Score. CACS was classified into zero, low (1-99), intermediate (100-399), high (400-899) and very high (>900) groups. CTA images were categorized into evaluable or not evaluable for stenosis due to severe calcification.
Of the 282 subjects, 90 (31.9%) demonstrated CTA-verified significant stenosis (>50% diameter narrowing) of at least one coronary artery. Invasive coronary angiography (CAG) was performed in 84 patients. Sensitivity, specificity, positive and negative predictive value of CTA was 91, 63, 91 and 63%, respectively. Relationship among CACS, evaluable image for stenosis, CT-verified stenosis and CAG-verified stenosis was shown in Table. Mean radiation dose of CTA was 6.7±4.6 mSv.
CTA after CACS seemed particularly more appropriate for asymptomatic patients with DM and low – high CACS (1-899) groups.
|CACS||N||Evaluable for Stenosis||%||CT-verified Stenosis||%||CAG-verified Stenosis||%|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality VI
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1230-372
- 2013 American College of Cardiology Foundation