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Titolo:
Usefulness of calcium scoring using electron beam computed tomography and noninvasive coronary angiography in patients with suspected coronary arterydisease
Autore:
Leber, AW; Knez, A; Mukherjee, R; White, C; Huber, A; Becker, A; Becker, CR; Reiser, M; Haberl, R; Steinbeck, G;
Indirizzi:
Univ Munich, Klinikum Grosshadern, Inst Internal Med 1, D-81377 Munich, Germany Univ Munich Munich Germany D-81377 ternal Med 1, D-81377 Munich, Germany Univ Munich, Klinikum Grosshadern, Inst Diagnost Radiol, D-81377 Munich, Germany Univ Munich Munich Germany D-81377 gnost Radiol, D-81377 Munich, Germany Univ Minnesota, Div Cardiol, Minneapolis, MN USA Univ Minnesota Minneapolis MN USA sota, Div Cardiol, Minneapolis, MN USA
Titolo Testata:
AMERICAN JOURNAL OF CARDIOLOGY
fascicolo: 3, volume: 88, anno: 2001,
pagine: 219 - 223
SICI:
0002-9149(20010801)88:3<219:UOCSUE>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
STENOSES; CT; CALCIFICATION; RECONSTRUCTIONS; QUANTIFICATION; SEVERITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Leber, AW Univ Munich, Klinikum Grosshadern, Inst Internal Med 1, Marchioninistr 15,D-81377 Munich, Germany Univ Munich Marchioninistr 15 Munich Germany D-81377 h, Germany
Citazione:
A.W. Leber et al., "Usefulness of calcium scoring using electron beam computed tomography and noninvasive coronary angiography in patients with suspected coronary arterydisease", AM J CARD, 88(3), 2001, pp. 219-223

Abstract

The aim of this study was to investigate the reliability of calcium scoring (CS) and electron beam computed tomographic angiography (EBCTA) as a noninvasive tool in the diagnosis of coronary artery disease (CAD): 93 consecutive patients (aged 59 +/- 9 years) with symptoms suspicious for CAD underwent CS. In 87 of these subjects, an additional EBCTA investigation was performed. Using receiver-operating characteristic curve analysis, we determineda calcium score cut point providing an overall sensitivity of 80% and a specificity of 72% in detecting patients with CAD. For clinical purposes the use of cut points is difficult. We therefore determined score ranges providing > 80% specificity (high score range) and > 85% sensitivity (low score range) and determined the scores between these ranges as equivocal borderline scores. Calculated on a per-segment basis in assessable proximal and midcoronary segments, the sensitivity for detecting coronary stenoses > 50% was78%, and the specificity was 93%. Thus, 32 of 44 patients with significantCAD and 24 of 49 patients without CAD were correctly classified. The combination of CS and EBCTA predicted CAD in 77% (72 of 93) of patients. No or low calcium scores provided high specificity for ruling out CAD. The addition of EBCTA in those patients improved sensitivity. In patients with high calcium scores, accuracy of EBCTA was not significantly different from CS alone (72% vs 83%), whereas in patients with borderline scores it was significantly superior (80% vs 58%, p <0.03). Thus, the complementary use of CS andEBCTA appears beneficial, particularly in patients with borderline scores,and could improve sensitivity in the low score range. in the presence of high scores, no major diagnostic gain from an additional EBCTA versus CS alone could be observed. (C) 2001 by Excerpta Medica, Inc.

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Documento generato il 27/09/20 alle ore 19:12:06