The diagnostic accuracy of coronary computed tomography angiography in patients with and without previous coronary interventions.

Autor:	Mansour HH; Radiology Department, Al-Shifa Hospital, Gaza-Palestine, Palestine; Medical Imaging Department, Al-Azhar University, Gaza-Palestine, Palestine. Electronic address: husam-rt2007@hotmail.com., Alajerami YS; Medical Imaging Department, Al-Azhar University, Gaza-Palestine, Palestine., Abushab KM; Medical Imaging Department, Al-Azhar University, Gaza-Palestine, Palestine., Quffa KM; Medical Imaging Department, Al-Azhar University, Gaza-Palestine, Palestine.
Jazyk:	angličtina
Zdroj:	Journal of medical imaging and radiation sciences [J Med Imaging Radiat Sci] 2022 Mar; Vol. 53 (1), pp. 81-86. Date of Electronic Publication: 2022 Jan 02.
DOI:	10.1016/j.jmir.2021.10.005
Abstrakt:	Background: Invasive coronary angiography (ICA) is the gold standard for imaging coronary arteries and the severity of coronary artery disease (CAD). Coronary computed tomography angiography (CCTA) has undergone remarkable progress in the diagnosis of CAD. Objectives: To evaluate the effect of prior vs no previous coronary interventions on the diagnostic accuracy of CCTA as an alternative to ICA to improve health outcomes for patients with suspected CAD. Methods: A prospective cohort study was carried out among patients suspected of CAD and for evaluation of grafts and stents to investigate recurrent ischemic symptoms. 120 patients imaged by CCTA were then referred to ICA, which is considered the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CCTA were assessed relative to ICA. Results: Based on a per-patient analysis, the comparison with ICA reveals variations in sensitivity, specificity, PPV, NPV and accuracy of CCTA. In patients without any previous coronary interventions, the sensitivity was 97.8%, and specificity was 95.6%. The PPV and NPV were 97.8% and 95.5%, respectively. Regarding patients with coronary artery bypass grafts (CABG), the sensitivity was 95% and specificity 100%. The PPV and NPV were 100% and 90.9%, respectively. Regarding patients with prior percutaneous coronary intervention (PCI), the results were a sensitivity of 84.6%, specificity of 77.8%, PPV of 84.6% and NPV of 77.8%. Conclusion: CCTA is a powerful diagnostic tool, especially for the evaluation of the major coronary arteries and evaluation of patients with prior CABG. ICA is recommended for evaluation of patients with an intracoronary stent. (Copyright © 2021. Published by Elsevier Inc.)
Databáze:	MEDLINE
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