Diagnostic Performance of 64-Channel Multislice Computed Tomography in Assessment of Significant Coronary Artery Disease in Symptomatic Subjects

Shabestari, Abbas Arjmand; Abdi, Seifollah; Akhlaghpoor, Shahram; Azadi, Mitra; Baharjoo, Hamidreza; Pajouh, Mohammad Danesh; Emami, Zyae; Esfahani, Fatemeh; Firouzi, Iraj; Hashemian, Mahmoud; Kouhi, M R Firouz; Mozafari, Mahmoud; Nazeri, Iraj; Roshani, Mahmoud; Salevatipour, Babak; Tavalla, Hedayatollah; Tehrai, Mahmoud; Zarrabi, Ali

doi:10.1016/j.amjcard.2007.01.040

Cited by 52 publications

(23 citation statements)

References 13 publications

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“…arteries [29] ( Table 1). Note that this method of reporting will, on average, underestimate the diagnostic power of CT coronary angiography because many patients have multiple significant coronary lesions.…”

Section: Ladapo Et Almentioning

confidence: 99%

Cost-Effectiveness of Coronary MDCT in the Triage of Patients with Acute Chest Pain

Ladapo

Hoffmann

Bamberg

et al. 2008

American Journal of Roentgenology

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C a r d i a c I m ag i ng • O r ig i n a l R e s e a rc h AJR 2008; 191:455-463 0361-803X/08/1912-455 © American Roentgen Ray Society P atients who present to the emergency department complaining of acute chest pain place a substantial economic burden on the U.S. health care system. In 2004 alone, more than 6 million such visits occurred, and an estimated 30% of them resulted in hospitalization for suspected acute coronary syndrome (ACS), a condition that includes myocardial infarction (MI) and unstable angina [1,2]. Although some of the many patients who are admitted because of these suspicions are ultimately diagnosed with ACS, many are not, and inpatient care for negative evaluations is estimated to cost several billion dollars annually [3].Patients who are at low risk for ACS because of negative initial cardiac biomarkers and normal or nondiagnostic ECG examinations, but in whom the source of chest pain is not readily identified, are a cohort whose management is notably inefficient [4][5][6][7]. The Funding for this study was provided through the Walker Fund of the Harvard Ph.D. Program in Health Policy, which provided support for the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation and review of the manuscript. Any errors or omissions are the sole responsibility of the authors. Joseph A. Ladapo had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.OBJECTIVE. Patients at low risk for acute coronary syndrome (ACS) who present to the emergency department complaining of acute chest pain place a substantial economic burden on the U.S. health care system. Noninvasive 64-MDCT coronary angiography may facilitate their triage, and we evaluated its cost-effectiveness. MATERIALS AND METHODS.A microsimulation model was developed to compare costs and health effects of performing CT coronary angiography and either discharging, stress testing, or referring emergency department patients for invasive coronary angiography, depending on their severity of atherosclerosis, compared with a standard-of-care (SOC) algorithm that based management on biomarkers and stress tests alone.RESULTS. Using CT coronary angiography to triage 55-year-old men with acute chest pain increased emergency department and hospital costs by $110 and raised total health care costs by $200. In 55-year-old women, the technology was cost-saving; emergency department and hospital costs decreased by $410, and total health care costs decreased by $380. Compared with the SOC, CT coronary angiography-based triage extended life expectancy by 10 days in men and by 6 days in women. This translated into corresponding improvements of 0.03 quality-adjusted life years (QALYs) and 0.01 QALYs, respectively. The incremental cost-effectiveness ratio for CT coronary angiography was $6,400 per QALY in men; in women, CT coronary angiography was cost-saving. Cost-effectiveness ratios were sensitive to several parameters but g...

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Section: Ladapo Et Almentioning

confidence: 99%

Cost-Effectiveness of Coronary MDCT in the Triage of Patients with Acute Chest Pain

Ladapo

Hoffmann

Bamberg

et al. 2008

American Journal of Roentgenology

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“…Those who showed no VT induction were also included in the NVT group. Ischemic heart disease was investigated in all patients by use of coronary angiography or 64-slice multidetector computed tomography (CT) 23,24 .…”

Section: Introductionmentioning

confidence: 99%

Realce Tardio miocárdico por Ressonância Magnética Cardíaca pode identificar risco para Taquicardia Ventricular na Cardiopatia Chagásica Crônica

Mello¹,

Szarf

Schvartzman³

et al. 2012

Arq. Bras. Cardiol.

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“…Pacientai tirti 16 pjūvių DKT aparatu (GE LightSpeed Pro 16 , Milwaukee, WI, USA), esančiu KMUK Radiologijos klinikoje. Pirmojo etapo metu buvo atliktas skenavimas, skirtas kalcio kiekiui vainikinėse arterijose nustatyti.…”

Section: Vainikinių Arterijų Tyrimas Dktunclassified

“…Lyginant su mūsų tyrimo duomenimis, šio tyrimo metu nustatytas aukštesnis jautrumas bei teigiama prognostinė vertė. Panašius duomenis pateikė ir kiti tyrėjai (16)(17)(18), įvertinę ³1,5 mm skersmens segmentus. Tuo tarpu A. W. Leber ir kolegos atliko tyrimą su 64 pjūvių DKT aparatu ir nustatė kiek žemesnį jautrumą (75 proc.).…”

Section: Spindžio Stenozės Vidurkis (Proc) Stenozės įVertinimo Skirtunclassified

Subintimal angioplasty: an alternative to open surgery of the lower limb chronic artery occlusion

Aleksynas

Kaupas²,

Antuševas³

2009

Medicina

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77,8 proc., specifiškumas -92,3 proc., teigiama prognostinė vertė -70 proc., neigiama prognostinė vertė -94,7 proc. Palyginus kiekvieno paciento tyrimų duomenis, kompiuterinės tomografijos jautrumas buvo 81,8 proc., specifiškumas -84,6 proc., teigiama prognostinė vertė -81,8 proc., neigiama prognostinė vertė -84,6 proc. Išvados. Vainikinių arterijų angiografija, atlikta daugiapjūviu kompiuteriniu tomografu, pasižymi aukštu diagnostiniu tikslumu nustatant hemodinamiškai reikšmingas stenozes esant kairiosios Hiso pluošto kojytės blokadai.Adresas susirašinėti: A. Jankauskas, KMU Radiologijos klinika, Eivenių 2, 50009 Kaunas El. paštas: jankauskas.antanas@gmail.com ĮvadasKairiosios Hiso pluošto kojytės blokada (KHPKB) yra susijusi su didesne širdies ir kraujagyslių ligų komplikacijų rizika, ypač pacientams, sergantiems išemine širdies liga (1-3). Todėl išeminės širdies ligos nustatymas pacientams, turintiems šį laidumo sutrikimą, padeda pasirinkti gydymo taktiką. Tačiau KHPKB, sąlygojanti nesinchronišką skilvelių kontrakciją ir relaksaciją, sunkina išeminės širdies ligos diagnostiką įprastiniais neinvaziniais tyrimo metodais (krūvio EKG, echokardioskopija) (4, 5). Krūvio radionuklidinės kompiuterinės tomografijos metu anteroseptalinėje srityje dažnai registruojami grįžtami perfuzijos defektai, kurių priežastis gali būti ne arterijos spindžio susiaurėjimas, o nesinchroniškos skilvelių veiklos sąlygotas miokardo mikrocirkuliacijos pablogėjimas (6, 7). Diagnozei patikslinti šiems pacientams dažnai tenka atlikti intervencinę vainikinių arterijų angiografiją. Todėl daugiapjūvės kompiuterinės tomografijos (DKT) tyrimas pastaruoju metu pradėtas taikyti ateroskleroziniams pokyčiams vainikinėse arterijose vizualizuoti, gali būti vertingas neinvazyvus diagnostikos metodas esant šio tipo laidumo sutrikimui (8).DKT aparatai sparčiai tobulinami, tačiau tiek 16 detektorių, tiek naujesnės kartos 64 detektorių aparatais atliktuose tyrimuose išlieka artefaktų, sąlygotų vainikinių arterijų judesio ar stambių kalcifikatų tikiMedicina (Kaunas) 2009; 45(4) KLINIKINIAI TYRIMAI

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Diagnostic Performance of 64-Channel Multislice Computed Tomography in Assessment of Significant Coronary Artery Disease in Symptomatic Subjects

Cited by 52 publications

References 13 publications

Cost-Effectiveness of Coronary MDCT in the Triage of Patients with Acute Chest Pain

Cost-Effectiveness of Coronary MDCT in the Triage of Patients with Acute Chest Pain

Realce Tardio miocárdico por Ressonância Magnética Cardíaca pode identificar risco para Taquicardia Ventricular na Cardiopatia Chagásica Crônica

Subintimal angioplasty: an alternative to open surgery of the lower limb chronic artery occlusion

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