Cardiology Letters 2022, 31(5):284-290

Determining optimal threshold for lumen stenosis in coronary CT angiography to select patients for heart catheterization: a single-centre retrospective analysis

Gibarti C¹, Urban L², Vicha B¹, Hanova K¹, Gallovicova A¹, Koribsky R¹, Majernik J³, Gal P$2Lukacin S⁴, Studencan M⁵

¹ Department of Radiology, East-Slovak Institute of Cardiovascular Diseases, Inc., Košice

² Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases, Inc., Košice

Aim: Due to high costs and invasiveness (resulting in discomfort/complications) coronary computed tomography angiography (CCTA) has become a clinically useful and relevant examination technique before cardiac catheterization. We aimed to retrospectively compare the utility of incorporating the CCTA data at the East-Slovak Institute of Cardiovascular Diseases into coronary interventions by direct comparison with data obtained following invasive coronary angiography (ICA) focusing on four coronary arteries (LM - left main stem, LDA - left anterior descending artery, CX - circumflex artery and RCA - right coronary artery).

Methods: The study was conducted on 394 patients (153 women and 241 men) within the period 2018-2020 that underwent both CCTA and ICA examinations. Heart coronary arteries were evaluated for the presence or absence of significant stenosis by comparing positive outcomes based on three levels of lumen reduction, i.e. ≥50%, ≥60% and ≥70%.

Results: We recorded overall sensitivity at 95.42%, 92.31% and 80.00% as well as specificity at 30.71%, 49.58% and 75.82%, corresponding to the three significant stenosis thresholds. Accordingly, the overall negative predicting values were recorded at 93.36%, 90.77% and 86.05%.

Conclusion: In summary, CCTA may be found useful in detecting significant coronary stenosis selecting patients for subsequent invasive procedure based on significant stenosis. We conclude that lumen reduction of ≥60% presents a fine balance between negative predicting value and sensitivity/specificity in the environment of our centre.

Kľúčové slová: coronary artery disease; coronary stenosis; CT imaging

Uverejnené: May 1, 2022  Zobraziť citáciu