MDCT angiography and coronary catheter angiography in patients with chest pain which is first

Abstract

Back ground: In some patients suffering from chest pain, we must start by non-invasive coronary CT angiography (CCTA) to protect these patients from unnecessary invasive coronary catheter angiography (CCA). Objective: Value of CCTA as the first diagnostic imaging modality in patient suffering from chest pain. Patients and methods: A total number of 100 patients were included in this study with mean age of 53.51 ± 11.6 years. Our patients were divided into two groups, group (A) included 60 patients underwent both CCTA and CCA and group (B) included 40 patients underwent CCTA only. Then Framingham Risk Score was applied for 68 cases (68%) after exclusion of cases with previous coronary artery intervention as CABG or stent (32 cases). Results: We were calculated a cutoff point of Framingham Risk Score at which p value <0.001, sensitivity 85.7%, specificity 51.5%, PPV 65.2%, NPV 77.3% and accuracy 69.1%, it was 7.5%. The diagnostic statistics of MDCT for CABG with sensitivity (100%) and specificity (100%). Conclusion: It is reasonable to start with CCTA in patients with Ferminghaim Risk Score less than 7.5%, filtering the patients to avoid unnecessary CCA. CCTA should be the first imaging modality in patients with CABG suffering from chest pain. Keywords: CCTA, CCA, Ferminghaim risk score, Coronary anomalies, Extra coronary cardiac and non- cardiac findings, CABG