title: Effect of age and plaque morphology on diagnostic accuracy of dual source multidetector computed tomography coronary angiography.
abstract: BACKGROUND
  Multidetector computed tomography (MDCT) coronary angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. The purpose of this study is to investigate the effect of age and coronary plaque calcification on diagnostic accuracy of MDCT.
  
  
  METHODS
  The patients were examined by using dual-source MDCT and conventional coronary angiography. MDCT results were analyzed with regard to the severity (> 50% stenosis) and morphology (non-calcified, mixed, or calcified) of coronary atherosclerotic plaques evaluated in a 16-segment model.
  
  
  RESULTS
  In total, 181 patients (94 men and 87 women) with 2,687 coronary artery segments were examined with MDCT. Ninety three patients were older than 65 years of age (group A, 42 men) and 88 were younger (group B, 52 men). Two-hundred nine coronary artery segments (7.2%) were excluded because of small distal coronary vessel segments and/or motion artifacts. The overall number of segments with non-diagnostic image quality was similar in both groups of patients. Of the 2,687 evaluated segments, 157 (5.8%) were significantly diseased, and 144 of them were correctly detected by MDCT. Diagnostic evaluation showed that the sensitivity, positive predictive value, specificity, and negative predictive value were 89.5%, 62.5%, 96.0%, and 99.2%, respectively in group A, and 95.2%, 64.8%, 97.5%, and 99.8% in group B, respectively. In addition, detailed segment-based analyses in coronary segments with non-calcified, mixed and calcified plaques in both groups were similar diagnostic accuracy.
  
  
  CONCLUSIONS
  Very high diagnostic accuracy observed in this study suggests that MDCT coronary angiography could be a suitable diagnostic tool for not only younger patients but also for older patients.
authors.affiliation: Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, 06110, Ankara, Turkey.
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.affiliation: Department of Cardiology, Türkiye Yüksek İhtisas Hospital, 06100, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Taher
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Edis
authors.initials: E
authors.lastname: Demiri
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazırolan
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Ergün B
authors.initials: EB
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakçı
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoğlu
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
keywords: Age; Calcification; Computed tomography; Coronary artery disease