Early detection of coronary artery disease by 64-slice multidetector computed tomography in asymptomatic hypertensive high-risk patients
Gaudio C et al. – The 64-slice multidetector-row computed tomography (MDCT) is an excellent noninvasive technique for early identification of significant coronary stenoses in high-risk asymptomatic hypertensive pts and may provide unique information for screening this broad population. Methods- Study of the value of MDCT vs invasive coronary angiography (ICA) for detecting presence and extent of coronary atherosclerotic plaques in a population of asymptomatic, hypertensive pts considered at high risk for cardiovascular events
- Assessment of 67 asymptomatic, hypertensive pts at high-risk (Euro Score >5%)
- Both MDCT and ICA for all pts (all had negative or nondiagnostic findings at exercise stress testing)
Results- In per-pt analysis, MDCT correctly identified 16/17 (94%) pts with significant coronary artery disease involving ≥1 vessel and 48/50 (96%) normal subjects
- In per-segment analysis, MDCT correctly detected 21/22 (95%) coronary segments with stenosis ≥50% and 856/868 (98%) normal segments, with high negative predictivity of normal scans (100%)
- Good concordance between MDCT and ICA; high Pearson correlation coefficient between coronary narrowings with the 2 techniques
- Mean coronary calcium score higher on ICA for 17 pts with vs 50 pts without significant coronary artery disease
- ROC curves identified 160 as best calcium volumetric score cut-off value able to identify ≥1 significant coronary stenosis with sensitivity 88% and specificity 85%
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