Contrast enhanced multi-detector computed tomography coronary angiography versus conventional invasive quantitative coronary angiography in acute coronary syndrome patients-correlation and bias.
BACKGROUND
Previous studies that compared multi-detector computed tomography (MDCT) non-invasive coronary angiography with conventional coronary angiography, did not assessed the ability of MDCT to detect stenotic lesions correctly in acute coronary syndromes (ACS) patients. The aim of the present study was to assess prospectively the correlation and bias between 16-slice MDCT coronary angiography and quantitative coronary angiography analysis (QCA) in these patients.


METHODS
Patients underwent electrocardiogram-gated, 16-slice MDCT coronary angiography and routine invasive percutaneous coronary angiography with quantitative coronary angiography (QCA) analysis blinded to MDCT results. The correlation and the bias between the results of MDCT and QCA were assessed in segments observed by both modalities in vessels > or = 2 mm in diameter.


RESULTS
59 patients (81% male, age 56 +/- 11 years), admitted due to ACS, underwent MDCT and invasive coronary angiography. 544 segments were analyzed. The correlations between MDCT and QCA observed for the left anterior descending coronary artery (LAD), the left circumflex coronary artery (Cx), the right coronary artery (RCA) and for all analyzed segments were 0.74 (P < 0.0001), 0.54 (P < 0.009), 0.72 (P < 0.0001) and 0.70 (P < 0.0001), respectively. By Bland-Altman analysis, a small overestimation of the lesion severity with MDCT of 4.8% for the LAD, 5.9% for the Cx, and 3.3% for the RCA was observed.


CONCLUSIONS
In ACS patients, MDCT contrast-enhanced coronary angiography provides good quantification of the luminal diameter as compared to coronary angiography, and it is characterized by a small overestimation bias.
Dragu
Robert
R
Division of Invasive Cardiology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, The Technion-Isreal Institute of Technology, Haifa, Isreal. dragu@tx.technion.ac.il
Rispler
Shmuel
S
Ghersin
Eduard
E
Gruberg
Luis
L
Lessick
Jonathan
J
Litmanovich
Diana
D
Aronson
Doron
D
Hammerman
Haim
H
Ofer
Amos
A
Engel
Ahuva
A
Beyar
Rafael
R
D000789:Angina, Unstable / Q000000981:diagnostic imaging*; D003287:Contrast Media; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide