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Objective To evaluate and analyze the diagnostic accuracy of 256-slice computed topographic angiog-raphy (CTA) and coronary angiography (CAG) in patients with coronary artery disease (CAD). Methods One hundred and one patients (suspected CAD and confirmed CAD with re-examination) underwent the 256-slice CTA and CAG were includ-ed in this study. The coronary artery imaging data of 101 patients were retrospectively collected and analyzed. Calculations for accuracy were conducted on a segmental basis. A total of 1 313 comparable segments were evaluated. The accuracy of 256-slice CTA was evaluated in the diagnosis of moderate and severe stenosis of coronary artery(stenosis in segments of cor-onary artery≥50%). The values for diagnostic accuracy of 256-slice CTA were analyzed, including mild stenosis: ＜50%, moderate stenosis:50%~75%, severe stenosis:76%~100%and complete occlusion. Results The sensitivity of 256-slice CTA for diagnostic accuracy to coronary heart disease was 94.87%, and the specificity was 52.17%. The positive predictive value was 87.06%and the negative predictive value was 75.00%. The accuracy rates of 256-slice CTA for evaluating the cor-onary artery stenosis were:mild stenosis (44.23%), moderate stenosis (44.23%), severe stenosis (40.00%) and total occlusion of coronary artery (51.77%), respectively. Conclusion The diagnostic value of 256-slice CTA for the degree of coronary ar-tery stenosis is insufficient, which can be used as a potential alternative screening examination to detect coronary artery ste-nosis in suspected patients and a method of re-examination in low risk patients with CAD.
RESUMO
Objective To compare the efficiency and safety of aspirin-dipyridamole and warfarin in the prevention of thromboembolism in patients with nonvalvular atrial fibrillation(NVAF)and high risk factors.Methods One hundred and forty NVAF patients with high risk factors were randomly divided into two groups.Warfarin group[78 cases international normalized ratio(INR)2.0-3.0,for the patients older than 75 years,INR ranging from 1.6 to 2.5]and combination group(62 cases received aspirin 160 mg once every day plus dipyridamole 160 mg 3 times every day).The incidence of death,thromboembolism(including stroke and peripheral arteries embolism)and hemorrhage events were observed.Results Followed-up 12-28 months.In warfarin group,3 cases lost,2 cages had stroke,2 cases suffered from serious bleeding events,6 cases had minor bleeding events.In combination group,2 cases lost,6 cases had stroke,and 2 cases suffered from peripheral arteries embolism events,3 cases had minor bleeding events,but no serious bleeding events occurred.The incidence of thromboembolism in warfarin group wag,lower than that in combination group[2.7%(2/75)vs 13.3%(8/60),P<0.05].There was no significant difference of the bleeding rate between the two groups[10.7%(8/75)vs 5.0%(3/60),P>0.05].Conclusions Warfarin anticoagulative therapy is more effective than aspirin and dipyridamole antiplatelet dual therapy for the prevention of thromboembolism events in patients with NVAF and high risk factors.The major bleeding events in warfarin group occurs in patients with INR>3.0,so under intensive monitoring(INR 2.0-3.0),warfarin therapy is effective and safety.
