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

Cardiovascular Diabetology

Original Investigation

Mauro Canestrari¹  Gianluca Pontone²  Saima Mushtaq²  Piergiuseppe Agostoni²  Laura Antonioli²  Sarah Cortinovis²  Giovanni Ballerini²  Andrea Annoni²  Antonio L Bartorelli²  Daniele Andreini²  Mauro Pepi²  Cesare Fiorentini² 

[1] ASUR Marche, Ospedale Santa Croce, Fano, Italy;Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Milan, Italy;

关键词: Diabetes Mellitus Patient;    Invasive Coronary Angiography;    Coronary Plaque;    Significant Coronary Artery Disease;    Suspected Coronary Artery Disease;   

DOI  :  10.1186/1475-2840-9-80

 received in 2010-09-07, accepted in 2010-11-29,  发布年份 2010

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Andreini et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.