Preoperative evaluation for coronary atherosclerosis with computed tomography angiography in intravenous drug users: an emerging indication in the face of a growing threat

Abstract

The purpose of this study was to describe the application of coronary computed tomography angiography (CCTA) in evaluation of patients with history of intravenous drug use (IDU). An IRB approved retrospective review was performed of all patients who had a prior history of IDU and presenting with endocarditis who had undergone CCTA. Demographic characteristics and cardiovascular risk factors were collected. In addition, we reviewed CCTA reports for dosimetric parameters, calcium score, and atherosclerotic burden. There were 32 patients (25 males) included in this study with a mean age of 38 ± 10.8 years. The average BMI for the study group was 26.5 ± 4.9. 44 % of patients had evidence of atherosclerotic disease on coronary CTA. Mean calcium score was 175 ± 487. Median total exam effective dose was 4.8 mSv (range: 3.3-7.3 mSv). In spite of their relatively young age and BMI at the upper limits of normal, patients with history of IDU have atherosclerosis and coronary CTA can be utilized to screen these patients and may be helpful for risk stratification prior to noncoronary surgical procedures. Given the recent rise in IDU, this may become a growing indication for CCTA.