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논문 기본 정보

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학술저널
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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제57권 제5호
발행연도
2016.1
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1,079 - 1,086 (8page)

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Purpose: To evaluate the ability of coronary computed tomographic angiography (CCTA) to predict the need of coronary revascularizationin symptomatic patients with stable angina who were referred to a cardiac catheterization laboratory for coronary revascularization. Materials and Methods: Pre-angiography CCTA findings were analyzed in 1846 consecutive symptomatic patients with stable angina, who were referred to a cardiac catheterization laboratory at six hospitals and were potential candidates for coronary revascularizationbetween July 2011 and December 2013. The number of patients requiring revascularization was determined based on the severity of coronary stenosis as assessed by CCTA. This was compared to the actual number of revascularization procedures performed in the cardiac catheterization laboratory. Results: Based on CCTA findings, coronary revascularization was indicated in 877 (48%) and not indicated in 969 (52%) patients. Of the 877 patients indicated for revascularization by CCTA, only 600 (68%) underwent the procedure, whereas 285 (29%) of the 969 patients not indicated for revascularization, as assessed by CCTA, underwent the procedure. When the coronary arteries were divided into 15 segments using the American Heart Association coronary tree model, the sensitivity, specificity, positive predictive value, and negative predictive value of CCTA for therapeutic decision making on a per-segment analysis were 42%, 96%, 40%, and 96%, respectively. Conclusion: CCTA-based assessment of coronary stenosis severity does not sufficiently differentiate between coronary segments requiring revascularization versus those not requiring revascularization. Conventional coronary angiography should be consideredto determine the need of revascularization in symptomatic patients with stable angina.
#Multidetector computed tomography #coronary artery disease #myocardial revascularization

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참고문헌 (23)

참고문헌 신청
Miller JM / 2008 / Diagnostic performance of coronary angiography by 64-row CT / N Engl J Med 359:2324~2336 google schola Meijboom WB / 2008 / Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study / J Am Coll Cardiol 52:2135~2144 google schola Schuetz GM / 2010 / Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging / Ann Intern Med 152:167~177 google schola Taylor AJ / 2010 / ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance / Circulation 122:e525~e555 google schola Min JK / 2012 / All-cause mortality benefit of coronary revascularization vs. medical therapy in patients without known coronary artery disease undergoing coronary computed tomographic angiography: results from CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: an InteRnational Multicenter Registry) / Eur Heart J 33:3088~3097 google schola

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