Safety and accuracy of multidetector row computed tomography for early assessment of residual stenosis of the infarct-related artery and the number of diseased vessels after acute myocardial infarction

Kuan Rau Chiou, Ming Ting Wu, Shih Hung Hsiao, Guang Yuan Mar, Huay Ben Pan, Chien Fang Yang, Chun Peng Liu

Research output: Contribution to journalArticle

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Abstract

Background: Recent studies reveal that contrast-enhanced multidetector row computed tomography (MDCT) is a promising technique for noninvasive visualization of coronary artery stenoses. We investigated the safety and accuracy of MDCT for early assessment of the severity of residual stenosis of the infarct-related artery (IRA) and the number of diseased vessels in patients after acute myocardial infarction (AMI). Methods and Results: Of 146 AMI cases admitted, 72 fit with criteria and underwent 16-slice MDCT (4 ± 2 days after AMI) with β-blockers. There were no complications except 1 patient who had from complete atrioventricular block. Results were compared with conventional coronary angiography (CCA) within 3 days. In 55 (73.3%) of 72 patients, all arteries were assessable. In total, the number of assessable arteries was 253 (87.8%), and 35 (12.2%) vessels were nonassessable, mostly because of motion artifacts and extensive calcification. Overall, 84 of the 115 lesions (≥50% lumen reduction) were correctly detected by MDCT (sensitivity 73.0%). The accuracy in classifying patients with nonsignificant, single-, or multiple-vessel diseases was 79.1%. The accuracy for residual lesions with >50% stenosis of IRA was 87.5%. There was a good correlation regarding the severity of residual stenosis of the IRA (0%, 1%-49%, 50%-89%, 90%-99%, or occlusion) between MDCT and CCA (Spearman correlation 0.94, P < .001). Lesions with 90% to 99% or occlusion of the IRA were accurately detected or ruled out in 31 of 36 cases (86.1%). Conclusions: With appropriate protocol, MDCT is safe and accurate in assessing the severity of IRA and the number of diseased vessels during the first week after AMI. It has the potential to provide triage for early management of patients after AMI.

Original languageEnglish
Pages (from-to)701-708
Number of pages8
JournalAmerican Heart Journal
Volume149
Issue number4
DOIs
Publication statusPublished - Jan 1 2005
Externally publishedYes

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Multidetector Computed Tomography
Pathologic Constriction
Arteries
Myocardial Infarction
Safety
Coronary Angiography
Atrioventricular Block
Triage
Coronary Stenosis
Artifacts

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Safety and accuracy of multidetector row computed tomography for early assessment of residual stenosis of the infarct-related artery and the number of diseased vessels after acute myocardial infarction. / Chiou, Kuan Rau; Wu, Ming Ting; Hsiao, Shih Hung; Mar, Guang Yuan; Pan, Huay Ben; Yang, Chien Fang; Liu, Chun Peng.

In: American Heart Journal, Vol. 149, No. 4, 01.01.2005, p. 701-708.

Research output: Contribution to journalArticle

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abstract = "Background: Recent studies reveal that contrast-enhanced multidetector row computed tomography (MDCT) is a promising technique for noninvasive visualization of coronary artery stenoses. We investigated the safety and accuracy of MDCT for early assessment of the severity of residual stenosis of the infarct-related artery (IRA) and the number of diseased vessels in patients after acute myocardial infarction (AMI). Methods and Results: Of 146 AMI cases admitted, 72 fit with criteria and underwent 16-slice MDCT (4 ± 2 days after AMI) with β-blockers. There were no complications except 1 patient who had from complete atrioventricular block. Results were compared with conventional coronary angiography (CCA) within 3 days. In 55 (73.3{\%}) of 72 patients, all arteries were assessable. In total, the number of assessable arteries was 253 (87.8{\%}), and 35 (12.2{\%}) vessels were nonassessable, mostly because of motion artifacts and extensive calcification. Overall, 84 of the 115 lesions (≥50{\%} lumen reduction) were correctly detected by MDCT (sensitivity 73.0{\%}). The accuracy in classifying patients with nonsignificant, single-, or multiple-vessel diseases was 79.1{\%}. The accuracy for residual lesions with >50{\%} stenosis of IRA was 87.5{\%}. There was a good correlation regarding the severity of residual stenosis of the IRA (0{\%}, 1{\%}-49{\%}, 50{\%}-89{\%}, 90{\%}-99{\%}, or occlusion) between MDCT and CCA (Spearman correlation 0.94, P < .001). Lesions with 90{\%} to 99{\%} or occlusion of the IRA were accurately detected or ruled out in 31 of 36 cases (86.1{\%}). Conclusions: With appropriate protocol, MDCT is safe and accurate in assessing the severity of IRA and the number of diseased vessels during the first week after AMI. It has the potential to provide triage for early management of patients after AMI.",
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T1 - Safety and accuracy of multidetector row computed tomography for early assessment of residual stenosis of the infarct-related artery and the number of diseased vessels after acute myocardial infarction

AU - Chiou, Kuan Rau

AU - Wu, Ming Ting

AU - Hsiao, Shih Hung

AU - Mar, Guang Yuan

AU - Pan, Huay Ben

AU - Yang, Chien Fang

AU - Liu, Chun Peng

PY - 2005/1/1

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N2 - Background: Recent studies reveal that contrast-enhanced multidetector row computed tomography (MDCT) is a promising technique for noninvasive visualization of coronary artery stenoses. We investigated the safety and accuracy of MDCT for early assessment of the severity of residual stenosis of the infarct-related artery (IRA) and the number of diseased vessels in patients after acute myocardial infarction (AMI). Methods and Results: Of 146 AMI cases admitted, 72 fit with criteria and underwent 16-slice MDCT (4 ± 2 days after AMI) with β-blockers. There were no complications except 1 patient who had from complete atrioventricular block. Results were compared with conventional coronary angiography (CCA) within 3 days. In 55 (73.3%) of 72 patients, all arteries were assessable. In total, the number of assessable arteries was 253 (87.8%), and 35 (12.2%) vessels were nonassessable, mostly because of motion artifacts and extensive calcification. Overall, 84 of the 115 lesions (≥50% lumen reduction) were correctly detected by MDCT (sensitivity 73.0%). The accuracy in classifying patients with nonsignificant, single-, or multiple-vessel diseases was 79.1%. The accuracy for residual lesions with >50% stenosis of IRA was 87.5%. There was a good correlation regarding the severity of residual stenosis of the IRA (0%, 1%-49%, 50%-89%, 90%-99%, or occlusion) between MDCT and CCA (Spearman correlation 0.94, P < .001). Lesions with 90% to 99% or occlusion of the IRA were accurately detected or ruled out in 31 of 36 cases (86.1%). Conclusions: With appropriate protocol, MDCT is safe and accurate in assessing the severity of IRA and the number of diseased vessels during the first week after AMI. It has the potential to provide triage for early management of patients after AMI.

AB - Background: Recent studies reveal that contrast-enhanced multidetector row computed tomography (MDCT) is a promising technique for noninvasive visualization of coronary artery stenoses. We investigated the safety and accuracy of MDCT for early assessment of the severity of residual stenosis of the infarct-related artery (IRA) and the number of diseased vessels in patients after acute myocardial infarction (AMI). Methods and Results: Of 146 AMI cases admitted, 72 fit with criteria and underwent 16-slice MDCT (4 ± 2 days after AMI) with β-blockers. There were no complications except 1 patient who had from complete atrioventricular block. Results were compared with conventional coronary angiography (CCA) within 3 days. In 55 (73.3%) of 72 patients, all arteries were assessable. In total, the number of assessable arteries was 253 (87.8%), and 35 (12.2%) vessels were nonassessable, mostly because of motion artifacts and extensive calcification. Overall, 84 of the 115 lesions (≥50% lumen reduction) were correctly detected by MDCT (sensitivity 73.0%). The accuracy in classifying patients with nonsignificant, single-, or multiple-vessel diseases was 79.1%. The accuracy for residual lesions with >50% stenosis of IRA was 87.5%. There was a good correlation regarding the severity of residual stenosis of the IRA (0%, 1%-49%, 50%-89%, 90%-99%, or occlusion) between MDCT and CCA (Spearman correlation 0.94, P < .001). Lesions with 90% to 99% or occlusion of the IRA were accurately detected or ruled out in 31 of 36 cases (86.1%). Conclusions: With appropriate protocol, MDCT is safe and accurate in assessing the severity of IRA and the number of diseased vessels during the first week after AMI. It has the potential to provide triage for early management of patients after AMI.

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