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Early detection of coronary artery disease by 64-slice multidetector computed tomography in asymptomatic hypertensive high-risk patients
International Journal of Cardiology, 06/26/09

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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