Coronary Artery Stenosis in High-risk Patients: 64–Section CT and Coronary Angiography—Prospective Study and Analysis of Discordance

Gouya, H.; Varenne, Olivier; Trinquart, Ludovic; Touzé, Emmanuel; Vignaux, O.; Spaulding, Christian; Mas, Jean‐Louis; Sablayrolles, Jean‐Louis

doi:10.1148/radiol.2522081271

Cited by 22 publications

(18 citation statements)

References 27 publications

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“…However, there was no difference whether the iPad or the clinical workstation was used. As expected, when the analysis was simplified into binary terms of presence or absence of significant CAD (i.e., ≥ or <50 % stenosis), the agreement increased significantly to 87-90 %, similar to prior studies [15].…”

Section: Discussionsupporting

confidence: 86%

Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

et al. 2016

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The feasibility of remote reading of coronary CT examinations on tablet computers has not been evaluated. The purpose of this study is to evaluate the accuracy of coronary CT angiography reading using an iPad compared to standard 3D workstations. Fifty coronary CT angiography exams, including a spectrum of coronary artery disease and anatomic variants, were reviewed. Coronary CT angiography exams were interpreted by two readers independently on an iPad application (Siemens Webviewer) and a clinical 3D workstation at sessions 2 weeks apart. Studies were scored per vessel for severity of stenosis on a 0-3 scale (0 none, 1 <50 %, 2 ≥50-69 %, 3 ≥70 %). Coronary anomalies were recorded. A consensus read by two experienced cardiac imagers was used as the reference standard. Level of agreement with the reference for iPad and 3D workstations was compared. Multivariate logistic regression was used to analyze the relationship between agreement and display type and to adjust for inter-reader differences. For both readers, there was no significant difference in agreement with the reference standard for per-vessel stenosis scores using either the 3D workstation or the iPad. In a multivariable logistic regression analysis including reader, workstation, and vessel as co-variates, there was no significant association between workstation type or reader and agreement with the reference standard (p > 0.05). Both readers identified 100 % of coronary anomalies using each technique. Reading of coronary CT angiography examinations on the iPad had no influence on stenosis assessment compared to the standard clinical workstation.

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Section: Discussionsupporting

confidence: 86%

Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

et al. 2016

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“…The presence of coronary artery atherosclerosis was assessed using 64-section CT coronary angiography. 4,9 We previously reported excellent agreement between 2 investigators for the detection of coronary artery stenosis in segments ≥1.5 mm in diameter. 9 In the present study, all 64-section CT coronary angiographies were reviewed by a single experienced radiologist blinded to clinical data and results of cervicocephalic atherosclerosis assessment.…”

Section: Derivation Cohortmentioning

confidence: 90%

Predicting Asymptomatic Coronary Artery Diseasein Patients With Ischemic Stroke and Transient Ischemic Attack

Calvet

Song

Yoo

et al. 2014

Stroke

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“…12 In that study conducted in patients at high risk for CAD, 12 MSCT coronary angiography had a sensitivity of 100% and a specificity of 89% (compared with conventional coronary angiography) for detecting patients with Ն50% CAD. All MSCT coronary angiographies were reviewed by a single experienced radiologist blinded to clinical data.…”

Section: Msct Coronary Angiographymentioning

confidence: 98%

Prevalence of Asymptomatic Coronary Artery Disease in Ischemic Stroke Patients

et al. 2010

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Background-Coronary artery disease (CAD) is a significant cause of morbidity and mortality in stroke patients. Some patients with asymptomatic CAD might benefit from specific prevention, but the prevalence of asymptomatic CAD is not well known. We assessed the prevalence of Ն50% asymptomatic CAD in patients with ischemic stroke or transient ischemic attack and whether the prevalence is related to traditional vascular risk factors and cervicocephalic atherosclerosis. Methods and Results-From January 2006 to February 2009, consecutive patients between 45 and 75 years of age with nondisabling, noncardioembolic ischemic stroke or transient ischemic attack and no prior history of CAD were enrolled in the study. All patients had a 64-section computed tomography coronary angiography and a detailed cervicocephalic arterial workup. Risk factors were assessed individually and through the Framingham Risk Score. Among 300 patients included in the study, 274 had computed tomography coronary angiography. The prevalence of Ն50% asymptomatic CAD was 18% (95% confidence interval [CI], 14 to 23; nϭ50). Asymptomatic CAD was independently associated with traditional risk factors assessed individually and through the Framingham Risk Score (odds ratio [OR], 2.6; 95% CI, 1.0 to 7.6 for a 10-year risk of coronary heart disease of 10% to 19%; and OR, 7.3; 95% CI, 2.8 to 19.1 for a 10 year-risk of coronary heart disease Ն20%), the presence of at least 1 Ն50% cervicocephalic artery stenosis (OR, 4.0; 95% CI, 1.4 to 11.2), excessive alcohol consumption (OR, 3.1; 95% CI 1.3 to 7.3), and ankle brachial index Ͻ0.9 (OR, 2.2; 95% CI, 0.9 to 5.2). The prevalence of Ն50% asymptomatic CAD was also related to the extent of cervicocephalic atherosclerosis. Conclusions-About one fifth of patients with nondisabling, noncardioembolic ischemic stroke or transient ischemic attack have Ն50% asymptomatic CAD. In addition to vascular risk factors, the presence of Ն50% cervicocephalic artery stenosis is strongly related to Ն50%

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Coronary Artery Stenosis in High-risk Patients: 64–Section CT and Coronary Angiography—Prospective Study and Analysis of Discordance

Cited by 22 publications

References 27 publications

Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

Predicting Asymptomatic Coronary Artery Diseasein Patients With Ischemic Stroke and Transient Ischemic Attack

Prevalence of Asymptomatic Coronary Artery Disease in Ischemic Stroke Patients

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