%0 Journal Article
%T How to Reduce Unnecessary Invasive Angiograms When Patients Are Initially Evaluated by Coronary Computed Tomography?
%A Edouard Cheneau
%A Brunot Vahda
%A No¨¦mie Resseguier
%A Laurent Bernard
%A Annamaria Molon
%A Roch Giorgi
%A Dimitri Panagides
%J Advances in Computed Tomography
%P 13-19
%@ 2169-2483
%D 2013
%I Scientific Research Publishing
%R 10.4236/act.2013.21003
%X Purpose:When Coronary Computed Tomography (CCT) detects coronary obstruction, patients are regularly referred to invasive angiogram. With higher sensitivity than specificity, CCT might induce unnecessary angiograms (¡°false positive CCT¡±). We sought to determine the patients and CCT findings associated with false positive CCT. Methods: Patients were prospectively referred to CCT with a 64-slice CT scan for suspected CAD. Inclusion criteria were: 1) clinically suspected angina pectoris; or 2) suspected silent ischemia on resting EKG. Exclusion criteria were acute coronary syndrome and non sinus rhythm. Invasive coronary angiogram (ICA) was performed on the basis of CCT findings (stenosis >50%). Analysis was performed on a per patient basis. Results: Out of 702 patients, 228 had suspected significant stenosis by CCT and ICA was performed in 176 patients. Coronary stenosis >50% was not confirmed by ICA in 44 (25%). In multivariate analysis, we observed that atypical angina (OR 3.63,CI 1.43-9.66), silent ischemia (OR 5.11, CI 1.89-14.6) and number of suspected stenosed arteries by CCT (OR 1.81, CI 1.15-2.94) were independently predictive of false positive CCT (p < 0.05). Lesion location and coronary plaque characteristics did not impact on CCT accuracy. Conclusions:Performing CCT for atypical angina or silent ischemia is associated with higher rate of unnecessary invasive coronary angiograms. We failed to identify lesions characteristics prone to be ¡°false positive¡± of CCT.
%K Angina
%K Coronary Disease
%K Diagnosis
%K CCT
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=28557