Author + information
- Takeshi Kondo,
- Shinichiro Fujimoto,
- Kazuhisa Takamura,
- Hiroshi Arai,
- Tadaaki Orihara,
- Junichi Sugiyama,
- Makoto Kondo,
- Akira Endo,
- Hiroshi Fukazawa,
- Hideki Nagaoka,
- Akitsugu Oida,
- Shinichi Takase and
- Jagat Narula
Coronary artery calcium score (CACS) and/or CT angiography (CTA) do not find a place in the Appropriate Use Criteria for Cardiac CT 2010 in asymptomatic patients with high pretest probability. The purpose was to evaluate the role of CACS and/or CTA in this patient group.
CACS and CTA were performed using 320-MDCT in 4487 consecutive patients for suspected coronary artery disease. Of those, only 46 asymptomatic subjects carried high pretest probability >90% defined by Duke Clinical Score. CACS was classified into low (0-99), intermediate (100-399), high (400-899) and very high (>900) groups. CTA images were categorized into evaluable or not evaluable due to severe calcification. Significant stenosis was defined as >50% diameter narrowing.
All 46 subjects were old men (83±4 years; 75-91years). Mean CACS was 808±1702 (0–10842). Invasive coronary angiography (CAG) was performed in 16 patients, sensitivity, specificity, positive and negative predictive value were 100, 67, 93 and 100 %, 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 6.2±4.5 mSv.
Thirty-five percent (16/46) of the asymptomatic subjects at high pretest probability demonstrated CAG-verified significant stenosis. All such subjects were old men. CTA after CACS seemed particularly more appropriate for such patients with intermediate – high CACS (100-899).
|CACS||N||Evaluable for Stenosis||%||CT-verified Stenosis||%||CAG-verified Stenosis||%|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: CT/Multimodality II
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1141-342
- 2013 American College of Cardiology Foundation