Coronary computed tomography angiography – Tolerability of β-blockers and contrast media, and temporal changes in radiation dose

Pedersen, Charlotte; Thomsen, Camilla Fjord; Hosbond, Susanne; Thomassen, Anders; Mickley, Hans; Diederichsen, Axel Cosmus Pyndt

doi:10.3109/14017431.2014.951958

Cited by 9 publications

(3 citation statements)

References 29 publications

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“…Using low dose nCT for screening purposes will ultimately result, in increased radiation exposure to those participating. However, screening for AAA is a one-time event, which in combination with the advances made with modern CT-scanners reduces this risk greatly, making the risk negligible in these elderly males [ 22 ]. Thus, making nCT a worthwhile modality, since it allows for a more thorough CVD screening than US does, while not inducing illnesses.…”

Section: Discussionmentioning

confidence: 99%

Abdominal ultrasound-scanning versus non-contrast computed tomography as screening method for abdominal aortic aneurysm – a validation study from the randomized DANCAVAS study

2017

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BackgroundValidating non-contrast-enhanced computed tomography (nCT) compared to ultrasound sonography (US) as screening method for abdominal aortic aneurysm (AAA) screening.MethodsConsecutively attending men (n = 566) from the pilot study of the randomized Danish CardioVascular Screening trial (DANCAVAS trial), underwent nCT and US examination. Diameters were measured in outer-to-outer fashion. Sensitivity and specificity were done testing each modality against each other as reference standard. Measurements were tested for correlation, variance in diameters, and mean differences were tested using paired t-test.ResultsDue to logistics, 533 underwent both nCT and US. In four patients, aortae could not be visualized with US, and two of these had an AAA (>30 mm) as diagnosed by nCT. Using nCT 30 (5.7%, 95% CI: 4.2;7.5%) AAA were found. US failed to detect 9 of these, but diagnosed 3 other cases, resulting prevalence by US was 4.5% (95% CI: 3.0;6.6%). Additionally, 5 isolated iliac aneurysms (≥20 mm) (0.9%, 95% CI: 0.3;2.2%) were discovered by nCT.US performed reasonably, with sensitivity ranging from 57.1–70.4%, specificity however, ranged higher 99.2–99.6%. Comparably nCT performed with sensitivity ranging from 82.6–88.9%, nCTs specificity however ranged from 97.7–98.4%. Analysis showed good correlations with no tendency to increasing variance with increasing diameter, and no significant differences between nCT and US with means varying slightly in both axis.ConclusionsnCT seems superior to US concerning sensitivity, and is able to detect aneurysmal lesions not detectable with US. Finally, the prevalence of AAA in Denmark seems to remain relatively high, in this small pilot study group.

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Section: Discussionmentioning

confidence: 99%

Abdominal ultrasound-scanning versus non-contrast computed tomography as screening method for abdominal aortic aneurysm – a validation study from the randomized DANCAVAS study

2017

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“…Although CIN is usually transient, few patients may develop persistent renal damage and an increased risk of cardiovascular events [135,136]. Compared to catheter-based intracoronary procedures, the occurrence of CIN following intravenous contrast administration during contrast-enhanced CT is much lower and virtually absent in patients with normal renal function [137][138][139].…”

Section: Risk Of Complications Associated With Coronary Atherosclerosmentioning

confidence: 99%

Coronary Atherosclerosis Imaging

et al. 2020

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Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of disease. Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques. Most acute coronary events are triggered by plaque rupture or erosion. Hence, atherosclerotic plaque imaging has generally focused on the detection of vulnerable plaque prone to rupture. However, atherosclerosis is a dynamic process and the plaque morphology and composition may change over time. Most vulnerable plaques undergo progressive transformation from high-risk to more stable and heavily calcified lesions, while others undergo subclinical rupture and healing. Although extensive plaque calcification is often associated with stable atherosclerosis, the extent of coronary artery calcification strongly correlates with the degree of atherosclerosis and with the rate of future cardiac events. Inflammation has a central role in atherogenesis, from plaque formation to rupture, hence in the development of acute coronary events. Morphologic plaque assessment, both invasive and non-invasive, gives limited information as to the current activity of the atherosclerotic disease. The addition of nuclear imaging, based on radioactive tracers targeted to the inflammatory components of the plaques, provides a highly sensitive assessment of coronary disease activity, thus distinguishing those patients who have stable disease from those with active plaque inflammation.

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“…In this issue of the Scandinavian Cardiovascular Journal, two Danish reports on local experiences related to the use of coronary CTA in routine clinical practice are presented (7,8). Both reports show an impressive decline over a 4-year time span in the effective radiation dose associated with "real-world" coronary CTA, both by using conventional 64-slice CT technology (from >17 to -5 mSv) (8) and by using a more recent CT scanner technology (from > 4 to ~ 2 mSv) (7).…”

mentioning

confidence: 99%

Coronary CT angiography in clinical practice: Experiences from Denmark

Nørgaard

2014

Scandinavian Cardiovascular Journal

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Coronary computed tomography angiography – Tolerability of β-blockers and contrast media, and temporal changes in radiation dose

Abstract: In terms of the side effects of β-blockers and contrast media, there were no short term complications to CCTA. Furthermore, the radiation dose has been dramatically diminished over the last three years.

Cited by 9 publications

References 29 publications

Abdominal ultrasound-scanning versus non-contrast computed tomography as screening method for abdominal aortic aneurysm – a validation study from the randomized DANCAVAS study

Abdominal ultrasound-scanning versus non-contrast computed tomography as screening method for abdominal aortic aneurysm – a validation study from the randomized DANCAVAS study

Coronary Atherosclerosis Imaging

Coronary CT angiography in clinical practice: Experiences from Denmark

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