Ultrafast Computed Tomography as a Diagnostic Modality in the Detection of Coronary Artery Disease

Abstract

Ultrafast CT scanning is an noninvasive, non-exercise-dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.

Inverse Relation of Total Serum Bilirubin to Coronary Artery Calcification Score Detected by Multidetector Computed Tomography in Males

“…We considered a CAC score of 100 as a marker of significant disease based on the recent data, which suggested the similarity of the cardiovascular risk when the CAC score was between 1 to 100, and a progressive increase of this risk when the CAC score was >100 after adjusting for traditional cardiovascular risk factors. 17 A high CAC score is observed in patients with documented CAD 18 and is closely related to age; its prevalence increases dramatically after age 50 years in males. 19 Therefore, the age of 50 years was assigned as the cutoff value in this study.…”

Electron Beam Computed Tomographic Coronary Calcium Scanning: A Review and Guidelines for Use in Asymptomatic Persons

“…Budoff and associates, 34 however, found specificity for significant disease to increase with the number of calcified vessels: 54% for one-vessel calcification and 78%, 89%, and 98% for two-, three-, and four-vessel calcification, respectively. To address the issues of calcification specificity in a more comprehensive manner, Kaufmann and coworkers 35 performed receiver operating characteristic analysis in 160 patients who underwent coronary angiography, followed by EBCT.…”

“…Most notably, the absence of coronary calcium was found in younger patients who tended to be active cigarette smokers and who had minimal or no focal atherosclerosis detected on intravascular ultrasonography. In a separate multicenter study by Budoff and colleagues, 34 EBCT demonstrated coronary calcium in 404 of 427 patients subsequently found to have angiographically confirmed significant coronary disease (95% sensitivity). Thus, the predominant theory from the literature is that coronary calcium detected by EBCT has a very high sensitivity for significant histologic and angiographic luminal disease.…”

Usefulness of Regional Distribution of Coronary Artery Calcium to Improve the Prediction of All-Cause Mortality

“…This concept has been subsequently highlighted with the use of non-contrast coronary CT (16), and in the histologic analysis of coronary artery segments (17). In the latter study, CAC quantification was an excellent predictor of coronary artery plaque burden within each coronary artery (left anterior descending coronary artery: r=0.89, p < 0.0001; left circumflex coronary artery: r=0.7, p < 0.001; right coronary artery: r=0.89, p < 0.0001).…”