334 Predictive Value of Cardiac Computed Tomography and the Impact of Renal Function on All Cause Mortality in Confirm: Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry

2012 ◽  
Vol 28 (5) ◽  
pp. S221-S222
Author(s):  
G. Dwivedi ◽  
M. Cocker ◽  
Y. Yam ◽  
S. Achenbach ◽  
M. Al-Mallah ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Function ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Coronary Computed Tomography Angiography ◽  
Cardiac Computed Tomography ◽  
All Cause Mortality ◽  
The Impact ◽  
International Multicenter ◽  
Multicenter Registry

scholarly journals The Functional Severity Assessment of Coronary Stenosis Using Coronary Computed Tomography Angiography-Based Myocardial Mass at Risk and Minimal Lumen Diameter

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kenji Sadamatsu ◽  
Kazuhiro Nagaoka ◽  
Yasuaki Koga ◽  
Kotaro Kagiyama ◽  
Kohei Muramatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Coronary Computed Tomography Angiography ◽  
Quantitative Coronary Angiography ◽  
Myocardial Mass ◽  
Coronary Computed Tomography ◽  
Minimal Lumen Diameter

Background. We investigated whether or not the addition of myocardial mass at risk (MMAR) to quantitative coronary angiography was useful for diagnosing functionally significant coronary stenosis in the daily practice. Methods. We retrospectively enrolled 111 consecutive patients with 149 lesions who underwent clinically indicated coronary computed tomography angiography and subsequent elective coronary angiography with fractional flow reserve (FFR) measurement. MMAR was calculated using a workstation-based software program with ordinary thin slice images acquired for the computed tomography, and the minimal lumen diameter (MLD) and the diameter stenosis were measured with quantitative coronary angiography. Results. The MLD and MMAR were significantly correlated with the FFR, and the MMAR-to-MLD ratio (MMAR/MLD) showed a good correlation. The area under the receiver operating characteristic curve (AUC) of MMAR/MLD for FFR ≤ 0.8 was 0.746, and the sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 83%, 68%, and 77%, respectively, at a cut-off value of 29.5 ml/mm. The addition of MMAR/MLD to diameter stenosis thus made it possible to further discriminate lesions with FFR ≤ 0.8 (AUC = 0.750). For the proximal left coronary artery lesions, in particular, MMAR/MLD showed a better correlation with the FFR, and the AUC of MMAR/MLD for FFR ≤ 0.8 was 0.919 at a cut-off value of 31.7 ml/mm. Conclusions. The index of MMAR/MLD correlated well with the physiological severity of coronary stenosis and showed good accuracy for detecting functional significance. The MMAR/MLD might be a useful parameter to consider when deciding the indication for revascularization.

scholarly journals Serial coronary computed tomography angiography-verified coronary plaque progression: comparison of stented patients with or without diabetes

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Rui Shi ◽  
Ke Shi ◽  
Zhi-gang Yang ◽  
Ying-kun Guo ◽  
Kai-yue Diao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Diabetic Patients ◽  
Plaque Progression ◽  
Coronary Computed Tomography ◽  
Number Of Patients ◽  
The Impact

Abstract Background Patients with Diabetes mellitus (DM) are susceptible to coronary artery disease (CAD). However, the impact of DM on plaque progression in the non-stented segments of stent-implanted patients has been rarely reported. This study aimed to evaluate the impact of DM on the prevalence, characteristics and severity of coronary computed tomography angiography (CCTA) verified plaque progression in stented patients. A comparison between diabetic and non-diabetic patients was performed. Methods A total of 98 patients who underwent clinically indicated serial CCTAs arranged within 1 month before and at least 6 months after percutaneous coronary intervention (PCI) were consecutively included. All the subjects were categorized into diabetic group (n = 36) and non-diabetic groups (n = 62). Coronary stenosis extent scores, segment involvement scores (SIS), segment stenosis scores (SSS) at baseline and follow-up CCTA were quantitatively assessed. The prevalence, characteristics and severity of plaque progression was evaluated blindly to the clinical data and compared between the groups. Results During the median 1.5 year follow up, a larger number of patients (72.2% vs 40.3%, P = 0.002), more non-stented vessels (55.7% vs 23.2%, P < 0.001) and non-stented segments (10.3% vs 4.4%, P < 0.001) showed plaque progression in DM group, compared to non-DM controls. More progressive lesions in DM patients were found to be non-calcified plaques (31.1% vs 12.8%, P = 0.014) or non-stenotic segments (6.6% vs 3.0%, p = 0.005) and were more widely distributed on left main artery (24.2% vs 5.2%, p = 0.007), the right coronary artery (50% vs 21.1%, P = 0.028) and the proximal left anterior artery (33.3% vs 5.1%, P = 0.009) compared to non-DM patients. In addition, DM patients possessed higher numbers of progressive segments per patient, ΔSIS and ΔSSS compared with non-DM individuals (P < 0.001, P = 0.029 and P < 0.001 respectively). A larger number of patients with at least two progressive lesions were found in the DM group (P = 0.006). Multivariate logistic regression analysis demonstrated that DM (OR: 4.81; 95% CI 1.64–14.07, P = 0.004) was independently associated with plaque progression. Conclusions DM is closely associated with the prevalence and severity of CCTA verified CAD progression. These findings suggest that physicians should pay attention to non-stent segments and the management of non-stent segment plaque progression, particularly to DM patients.

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