Zameer-ul Asara, Tahir Naveed, Shaima Abdul Ghaffar.
Accuracy of computed tomographic angiography for the detection of coronary collaterals as compared to conventional invasive angiography.
J Cardiovascular Dis Jan ;13(3):73-6.

ABSTRACT OBJECTIVE:To determine the accuracy of CT coronary angiography for visualization of collaterals in chronic totally occlusive coronary arteries in comparison to conventional invasive coronary angiography. MATERIAL AND METHOD:This cross sectional survey was conducted at Punjab Institute of Cardiology from August 2013 to February 2014. 185 patients were included in the study with total chronic occlusion of coronary arteries on conventional angiography. All patients underwent both conventional angiography and CT angiography. Different demographic variables were recorded for each patient. The statistical analysis was done using SPSS package version 19. Descriptive analysis was done i.e. frequencies and percentages for categorical variables like sex, coronary collaterals, and mean and standard deviation for the continuous variables like age was carried out. Sensitivity, Specificity, Positive and Negative predictive values and diagnostic accuracy of CT Angiography for presence and extent of coronary collaterals against Invasive Coronary Angiography were calculated by using 2/2 table. RESULTS:In our study, 185 patients were studied, mean age was calculated as 54±8 years, 135(73 %) male and 50 (27%) were female. Mean weight of the patients was 74.25±13 kg. Invasive Coronary angiography and CT angiography was performed in all the patients to compare the visualization of collaterals by taking Invasive Coronary Angiography as gold standard. Collaterals were visualized in 123 (66.5%) patients with Invasive Coronary Angiography while CT coronary angiography was able to pick the collaterals in 108 (58.4%). Sensitivity of CT was 84.5% and specificity of 93.5%. Positive predictive value was 96.3% and negative predictive value was 75.3%. Accuracy was calculated as 87.5%. CONCLUSION:Efficacy of CT is good with high sensitivity and specificity. CT is a noninvasive test as compared to invasive coronary angiography. So CT is a useful modality to be considered when necessary to visualize coronary collaterals for patients undergoing CABG/PCI. KEYWORDS:Coronary artery disease, Coronary artery collaterals, Multi-detector computed tomography, Coronary angiography

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