[Multislice computed tomography to detect coronary stenosis among asymptomatic patients with cardiovascular risk factors and equivocal prior stress test: preliminary study].
Multislice computed tomography (MSCT) is a non-invasive and validated technique to detect coronary stenoses. Some questions remain about its accuracy to detect coronary stenoses (CS), especially for asymptomatic patients (P) when a prior stress test isn't conclusive.


METHODS
MSCT was performed among 45 asymptomatic men (mean age: 58,3 +/- 16), with a high ten year risk of fatal cardiovascular disease (SCORE 2003 data for low-risk regions of Europe), without any previous coronary history and with previous non conclusive exercise testing. When significant (> 50%) CS was suspected at MSCT, an angiocoronarography (AC) was done.


RESULTS
Eighteen MSCT were normal, unsignificant CS (< 50%) were detected on 14 MSCT and significant coronary stenoses (SCS) for 13 P. Among this 13 P, 19 SCS were identified: 2 SCS of left main coronary artery (CA), 9 of the left descending CA, 6 of the right CA and 2 of the left circumflex CA. 13 CS were confirmed at AC. Finally, because of critical angiographic lesions +/- ischemia at nuclear tomoscintigraphy (NT), 9 P had coronary revascularization (7 catheter based, 2 surgical bypass), 4 P had medical treatment.


CONCLUSIONS
Benefits of this preliminary study are obvious: 9 coronary revascularization/45 P. However, the place of MSCT for the screening of CS is uncertain, but may be usefull as a complement for the screening of coronary arterial disease.
Perrier
E
E
Service de pathologie cardiovasculaire et de médecine aéronautique, hôpital d'Instruction-des-Armées-Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart, France.
Manen
O
O
Paul
J F
JF
Lerecouvreux
M
M
Quiniou
G
G
Geffroy
S
S
Deroche
J
J
Caussin
C
C
Doireau
P
P
Plotton
C
C
Carlioz
R
R
D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*