Comparison of the diagnostic performance of 64-slice computed tomography coronary angiography in diabetic and non-diabetic patients with suspected coronary artery diseaseReport as inadecuate




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Cardiovascular Diabetology

, 9:80

First Online: 29 November 2010Received: 07 September 2010Accepted: 29 November 2010

Abstract

BackgroundDiabetics have high prevalence of subclinical coronary artery disease CAD with typical characteristics diffuse disease, large calcifications. Although 64-slice multidetector computed tomography MDCT coronary angiography has high diagnostic accuracy to detect CAD, its diagnostic performance in diabetics with suspected CAD is unknown. To compare the diagnostic performance of 64-slice MDCT between diabetics and non-diabetics with suspected CAD scheduled for invasive coronary angiography ICA.

MethodsWe enrolled one hundred and five diabetic patients 92 men, age 65 +- 9 years, Group 1 and 105 non-diabetic patients 63 men, age 63+-5 years, Group 2 with indication to ICA for suspected CAD undergoing coronary 64-slice MDCT before ICA.

ResultsIn Group 1, the overall feasibility of coronary artery visualization was 93.8%. The most frequent artifact was blooming due to large coronary calcifications 54 artifacts, 67%. In Group 2, the overall feasibility was significantly higher vs. Group 1 97%, p < 0.0001. In Group 1, the segment-based analysis showed a MDCT sensibility, specificity, positive predictive value, negative predictive value and accuracy for the detection of ≥50% luminal narrowing of 77%, 90%, 70%, 93% and 87%, respectively. In Group 2, all these parameters were significantly higher vs. Group 1. In the patient-based analysis, specificity, negative predictive value and accuracy were significantly lower in Group 1 vs. Group 2.

ConclusionsAlthough MDCT has high sensitivity for early identification of significant CAD in diabetics, its diagnostic performance is significantly reduced in these patients as compared to non-diabetics with similar clinical characteristics.

Abbreviations ListCADcoronary artery disease

DMdiabetes mellitus

ICAinvasive coronary angiography

MDCTmultidetector computed tomography

NPVnegative predictive value

PPVpositive predictive value

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-9-80 contains supplementary material, which is available to authorized users.

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Author: Daniele Andreini - Gianluca Pontone - Antonio L Bartorelli - Piergiuseppe Agostoni - Saima Mushtaq - Laura Antonioli - Sara

Source: https://link.springer.com/article/10.1186/1475-2840-9-80







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