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Subject Area

General Surgery

Article Type

Original Study

Abstract

Objectives To assess the diagnostic accuracy of the computed tomography-coronary angiography (CT-CA) in detecting coronary artery disease compared with catheter coronary angiography (CCA). Background CT-CA is now considered an alternative tool of accurate and safe detection of coronary artery disease as it is rapid and noninvasive. Patients and methods This prospective study was conducted during the period between January 2017 and October 2018, including 121 patients (74 male and 47 female; mean age, 57.5 + 10.5 years) complaining of chest pain referred from cardiology outpatient clinics, Menoufia University Hospitals, for CT-CA. Patients were classified into two groups: group A underwent both CT-CA and CCA and included 41 patients (24 without previous coronary intervention, 11 had undergone previous coronary artery bypass graft, and six with previous coronary stenting), and group B included 80 patients and underwent only CT-CA, as another cause of chest pain was diagnosed or coronary significant stenosis was excluded, so patients were not candidates for CCA. Results Compared with CCA, CT-CA demonstrated sensitivity, specificity, and accuracy for detecting significant stenosis in coronary arteries of 97.1, 96.8, and 96.8%, respectively. The included 33 grafts CT-CA confirm the patency of additional five (15%) grafts that failed to be cannulation by CCA. The included nine stents showed six patents and three occluded by both CCA and CT-CA. CT-CA visualized extracoronary findings were not visualized by CCA. Conclusion CT-CA is a reliable coronary artery stenosis evaluation tool for assessment of grafts and stent patency, as well as detection of extracoronary pathology; it can reduce the number of invasive CCA studies for those patients.

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