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Category: Volume 05 Issue 08 August 2017
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Title: Non-Invasive  Computed   Tomographic  Coronary  Angiography  for  Patients  with  Suspected  Coronary  Artery  Disease

Authors: Dr Vijay Thakur, Dr Hitender  Himral, Dr Ashwani Tomar, Dr Rajeev Bhardwaj, Dr Sushma Makhaik

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.72

Abstract

Introduction:  64 Slice CT is useful non-invasive sceening tool in evaluation of patients suspected of CAD with excellent temporal and spatial resolution. Excellent image quality is obtained by lowering heart rate <60 bpm. Atherosclerotic plaques causing stenosis can be differentiated into calcified , non-calcified and mixed density types which allow further planning for management of CAD.

Objective:  Our study aimed at quantification of coronary calcium by 64 slice MDCT and its implication for determining risk of cardiovascular events, detection of CAD and significant coronary artery stenosis (>50%  narrowing of lumen ).

Material & Methods: Our study included 60 patients suspected of CAD in pre-test clinical evaluation. All these patient were subjected to Calcium-scoring (by Agatston method,AJ-130, using  Smart score 4.0 software ) and Coronary Angiography  on 64 Slice MDCT  Scanner using 3D Workstation with vessel analysis software (Cardiac IQ Express 4.0 , GE Healthcare ).

Observations: CTCA detected significant CAD in about one-third of study population who were clinically suspected of having CAD on basis of symptoms and stress tests. No obstructive CAD was present in two-third of patients and CTCA prevented them to undergo cost-extensive Invasive Coronary Angiography (ICA). The atherosclerotic plaques causing stenosis could be differentiated into Calcified, non-calcified and mixed density , which helped in further planning for management of CAD.

Conclusion: CTCA is better than calcium score in evaluation of CAD. Patient with zero calcium score can harbour significant CAD which is reliably detected on CTCA. Therefore, CTCA is an excellent non-invasive tool in work-up of patients of CAD.

Keywords: CAD-coronary artery disease, CTCA- computed tomographic coronary angiography, ICA – invasive coronary angiography, CAC –coronary artery calcification, MDCT-multi-detector computed tomography, CS-Calcium score.

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Corresponding Author

Dr Vijay Thakur

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