TY - JOUR
T1 - Comparison of Intravascular Ultrasound to Contrast-Enhanced 64-Slice Computed Tomography to Assess the Significance of Angiographically Ambiguous Coronary Narrowings
AU - Okabe, Teruo
AU - Weigold, Wm Guy
AU - Mintz, Gary S.
AU - Roswell, Robert
AU - Joshi, Subodh
AU - Lee, Sung Yun
AU - Lee, Bongryeol
AU - Steinberg, Daniel H.
AU - Roy, Probal
AU - Pinto Slottow, Tina L.
AU - Smith, Kimberly
AU - Torguson, Rebecca
AU - Xue, Zhenyi
AU - Satler, Lowell F.
AU - Kent, Kenneth M.
AU - Pichard, Augusto D.
AU - Weissman, Neil J.
AU - Lindsay, Joseph
AU - Waksman, Ron
PY - 2008/10/15
Y1 - 2008/10/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=54549086752&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2008.05.066
DO - 10.1016/j.amjcard.2008.05.066
M3 - Article
C2 - 18929699
AN - SCOPUS:54549086752
SN - 0002-9149
VL - 102
SP - 994
EP - 1001
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -