Clinical Implications of Moderate Coronary Stenosis on Coronary Computed Tomography Angiography in Patients with Stable Angina
Yonsei Medical Journal
; : 937-944, 2018.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-717936
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
The present study investigated the diagnostic accuracy and clinical implications of moderate stenosis (50–69%, Coronary Artery Disease Reporting and Data System, grade 3) on coronary computed tomography angiography (CCTA), compared with invasive coronary angiography (ICA). MATERIALS ANDMETHODS:
Two hundred and seventy-six patients who underwent ICA due to moderate stenosis alone on CCTA were selected from our prospective registry cohort.RESULTS:
Diagnostic concordance between CCTA and ICA was found in only 50 (18%) patients. Among the 396 vessels and 508 segments with moderate stenosis, diagnostic concordance was found in 132 vessels (33%) and 127 segments (25%). Segments with calcified plaque had lower diagnostic concordance than those with mixed or non-calcified plaque (22% vs. 28% vs. 27%, respectively, p=0.001). While calcified plaque burden did not have an influence on severe stenosis (≥70%) on ICA, higher burden of non-calcified plaque was correlated with a greater incidence of ICA-based severe stenosis, which was more frequent in patients with ≥3 segments of non-calcified plaque (75%) than those without non-calcified plaque (22%, p < 0.001). Typical angina and mixed or non-calcified plaque were correlated with a higher incidence of under-diagnosis, while the use of next-generation computed tomography scanners reduced the incidence of under-diagnosis. Increased body weight, left circumflex artery involvement, and calcified plaque were independent factors that increased the risk of over-diagnosis of CCTA.CONCLUSION:
The diagnosis of moderate stenosis by CCTA may be limited in estimating the exact degree of ICA-based anatomical stenosis. Unlike calcific burden, non-calcific burden was positively correlated with the presence of severe stenosis on ICA.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
/
Doença Isquêmica do Coração
/
Obesidade
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Artérias
/
Peso Corporal
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Doença da Artéria Coronariana
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Sistemas de Informação
/
Angiografia
/
Incidência
/
Estudos Prospectivos
/
Estudos de Coortes
/
Angiografia Coronária
/
Constrição Patológica
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Yonsei Medical Journal
Ano de publicação:
2018
Tipo de documento:
Artigo