Comparison of Intravascular Ultrasound to Contrast-Enhanced 64-Slice Computed Tomography to Assess the Significance of Angiographically Ambiguous Coronary Narrowings

Teruo Okabe, Wm Guy Weigold, Gary S. Mintz, Robert Roswell, Subodh Joshi, Sung Yun Lee, Bongryeol Lee, Daniel H. Steinberg, Probal Roy, Tina L. Pinto Slottow, Kimberly Smith, Rebecca Torguson, Zhenyi Xue, Lowell F. Satler, Kenneth M. Kent, Augusto D. Pichard, Neil J. Weissman, Joseph Lindsay, Ron Waksman*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    20 Citations (Scopus)

    Abstract

    The efficacy of contrast-enhanced multislice computed tomography (MSCT) for assessment of ambiguous lesions is unknown. We compared both quantitative coronary angiography (QCA) and MSCT to the gold standard for a significant stenosis-minimum luminal area (MLA) by intravascular ultrasound (IVUS)-in 51 patients (64 ± 10 years old, 19 men) with 69 angiographically ambiguous, nonleft main lesions. The MSCT was performed 17 ± 18 days before IVUS analysis. Overall diameter stenosis by QCAwas 51.0 ± 9.8%; 39 of 51 patients (76%) eventually underwent revascularization (38 by percutaneous coronary intervention and 1 by coronary artery bypass graft). By univariate analysis, minimum luminal diameter, MLA, lumen visibility by MSCT, and minimum luminal diameter by QCA were significant predictors of MLA by IVUS ≤4.0 mm2. In mildly calcified lesions (calcium burden by MSCT ≤1), MLA by MSCT was a much better predictor than in more calcified lesions. By multivariate logistic regression analysis, only MLA by MSCT (odds ratio 0.754, 95% confidence interval 0.571 to 0.995, p = 0.0458) was predictive of MLA by IVUS ≤4.0 mm2. In conclusion, in angiographically ambiguous lesions in which QCA does not distinguish significantly from nonsignificant stenosis, MSCT-measured MLA can predict significant stenosis with MLA ≤4.0 mm2 measured by IVUS.

    Original languageEnglish
    Pages (from-to)994-1001
    Number of pages8
    JournalAmerican Journal of Cardiology
    Volume102
    Issue number8
    DOIs
    Publication statusPublished - 15 Oct 2008

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