Discrepancies between coronary CT angiography and invasive coronary angiography with focus on culprit lesions which cause future cardiac events.

Objectives: To evaluate the clinical significance of discrepant lesions between coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) in a longitudinal study.Methods: In 220 patients with suspected coronary artery disease (CAD) who underwent both 256-row CCTA and IC...

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Publicado en:European Radiology Vol. 28; no. 4; pp. 1356 - 1365
Autores principales: Kim, Junghoon, Kwag, Hyon Joo, Yoo, Seung Min, Yoo, Jin Young, Chae, In-Ho, Choi, Dong-Ju, Park, Min-Jae, Vembar, Mani, Chun, Eun Ju
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Apr2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2018
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      pub: Springer Nature
      place: New York, New York
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        atl: Discrepancies between coronary CT angiography and invasive coronary angiography with focus on culprit lesions which cause future cardiac events.
      aug:
        au:
          Kim, Junghoon
          Kwag, Hyon Joo
          Yoo, Seung Min
          Yoo, Jin Young
          Chae, In-Ho
          Choi, Dong-Ju
          Park, Min-Jae
          Vembar, Mani
          Chun, Eun Ju
        affil: Department of Radiology, Seoul National University Bundang Hospital, Sungnam, Korea
      sug:
        subj:
          Coronary Angiography Methods
          Radiography, Interventional Methods
          Coronary Arteriosclerosis
          Male
          Coronary Stenosis
          Prospective Studies
          Middle Age
          Predictive Value of Tests
          Female
          Reproducibility of Results
          Scales
          Funding Source
          Human
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objectives: To evaluate the clinical significance of discrepant lesions between coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) in a longitudinal study.Methods: In 220 patients with suspected coronary artery disease (CAD) who underwent both 256-row CCTA and ICA, the obstructive CAD (≥ 50% stenosis) on CCTA was compared with that on ICA as the reference standard. We analysed the causes of the discrepancy between CCTA and ICA. During a 40-month follow-up period, major adverse cardiac events (MACE) were assessed.Results: Discordance between CCTA and ICA was observed in 121 of the 3166 coronary artery segments (3.8%). Common causes were calcification (45.9%) and positive remodelling (PR) (29.6%) in 83 false positive lesions, and noise (40.0%) and motion artefact (37.8%) in 38 false negative lesions. MACE occurred in seven lesions among the discrepant lesions; six among the 29 PR lesions (20.7%) and one among the 53 calcified lesions (1.9%). With respect to the prediction power of MACE in an intermediate stenosis, the CCTA-related value including PR was higher than the ICA-related value.Conclusions: PR was a frequent cause of MACE among the false positive lesions on CCTA. Therefore, the presence of PR on CCTA may suggest clinical significance, although it can be missed by ICA.Key Points: • Compared to ICA, PR in CCTA may be cause of false positive lesion. • CCTA-related value including PR shows higher prediction power of MACE than ICA-related value. • PR reflects atherosclerotic burden that can be related to cardiac events. • PR in CCTA should be observed carefully, even if it is false positive.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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