8.2.4

CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY IN THE DIAGNOSIS OF CORONARY ARTERY DISEASE IN OUTPATIENT SETTINGS

El Manaa H.E.1, Shchekochikhin D.Yu.1, Shabanova M.S.2, Gognieva D.G.1, Lomonosova A.A.1, Gogiberidze N.A.1, Ternovoy S.K.1,2, Shariya M.A.1,2, Kondrashina O.S.1, Serova N.S.1, Mesitskaya D.F.1, Kopylov Ph.Y.1, Syrkin A.L.1

Purpose. The purpose of this study is to compare the diagnostic performance of coronary computed tomographic angiography (CCTA) and stress test as a first-line examination for the diagnosis of stable coronary artery disease in outpatient settings. Materials and methods. The study prospectively enrolled 74 patients with typical and atypical angina symptoms lasting longer than three weeks, mean age – 63,9±10,4 years, 28 (37,8%) women. Exclusion criteria: contraindications to iodine-containing contrast media, statins; GFR <45ml/min/1,73 sq m; inability to perform stress testing. All patients consist-ently underwent stress testing (standard Bruce protocol and The Modified Bruce protocol) and standard CCTA on a 640-slice CT scanner Toshiba Aquilion ONE. We determined pretest probability of CAD and stratified risks using SCORE and ACC/AHA scales. Statistical pro-cessing was performed with SPSS version 11,5 software. Results. Treadmill test results were positive in 51,4% of patients, among them ac-cording to CCTA: 19,15% had stenosis ≥ 70%, 35,3% had stenosis 50-69%. CCTA revealed that 28,6% of males and 46,2% of females with typical and 66,7% of males and 50,0% of fe-males with atypical angina symptoms with positive treadmill test had no evidence of athero-sclerotic lesions. 4,05% of patients with negative stress testing had evidence of significant arterial lesions (stenosis >70%). According to the SCORE risk estimation, 67,6% of patients with atherosclerotic changes in coronary arteries had high risk, ACC/AHA score – 70,6%. The sensitivity and specificity of the SCORE and ACC/AHA scales in revealing coronary ath-erosclerosis were 83% and 71%, 81% and 88%, respectively (p> 0.05). Conclusion. CCTA can be considered as a method for the primary diagnosis of stable coronary artery disease in outpatient practice.

1 - I.M. Sechenov First Moscow State Medical University (Sechenov University). 2 - National medical re-search center of cardiology. Moscow, Russia.


 

Keywords: computed tomography, stress test, pretest probability, risk score, atherosclerosis, coronary artery disease.

 

Corresponding author:Manaa H.E. El., email: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: El Manaa H.E., Shchekochikhin D.Yu., Shabanova M.S., Gognieva D.G., Lomonosova A.A., Gogiberidze N.A., Ternovoy S.K., Shariya M.A., Kondrashina O.S., Mesit-skaya D.F., Kopylov Ph.Y., Syrkin A.L. Coronary computed tomographic angiography in the diagnosis of coronary artery disease in outpatient settings. REJR 2018; 8 (2):40-48. DOI:10.21569/2222-7415-2018-8-2-40-48.

Received: 16.03.2018 Accepted: 01.06.2018