Increase of correctness in revascularization of coronary artery disease by first assessment of coronary computed tomography angiography / 中国中西医结合急救杂志

ABSTRACT

Objective To discuss the influence of coronary computed tomography angiography(CCTA)on correctness of assessing revascularization in patients with coronary artery disease. Methods A retrospective study method was conducted,605 cases underwent CCTA before coronary angiography(CAG)from 2008 to 2009 in Chinese PLA General Hospital were selected as CCTA before CAG group,and meanwhile 616 cases examined by CAG directly were selected as direct CAG group. Patients with multiple procedures of CAG were excluded. The proportions of various treatment strategies were compared,including per-cutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG),medical therapy(MT),normal rate of CAG and the correctness of assessing revascularization between the two groups. Results The comparison between the baseline of the two groups showed that in the CCTA before CAG group,there were more severe lesions than those in the direct CAG group,such as Syntax score(11.31±8.90 vs. 10.23±9.73,P<0.05). Compared with direct CAG group,the triage of PCI and CABG in the CCTA before CAG group was significantly increased〔PCI:65.3%(395/605)vs. 57.1%(352/616),CABG:16.5%(100/605)vs. 3.4%(21/616)〕,while the percentages of medical treatment and normal CAG were obviously reduced〔medical treatment:11.7%(71/605)vs. 19.3%(119/616),normal rate of CAG:6.4%(39/605)vs. 20.1%(124/616),all P<0.01〕. With the guidance of CCTA,the correctness of assessing revascularization was increased〔81.8%(495/605)vs. 60.6%(373/616),P<0.01〕. Conclusion Compared with the direct induction by CAG,the CCTA examination carried out before CAG is capable of increasing the rate of correctness in the determination of revascularization in coronary heart diseases.