A segment-to-segment agreement between findings of Cardiac Computed Tomography Angiography and invasive coronary artery angiography

Abstract

Abstract Introduction Increasing prevalence of ischaemic heart disease (IHD) requires reliable, convenient, and non-invasive screening methods for detection of IHD in early phases. Currently cardiac computed tomography angiography (CCTA) for evaluation for anatomy and in some cases, physiology using non-invasive methods are the method of choice low to moderate IHD patients. Unfortunately, sometimes it seems, that results of CCTA disagree with invasive coronary artery angiography (ICA) results. There was no systemic analysis of segment-to-segment stenosis significance comparison between these two methods (CCTA vs ICA). Therefore, this study aimed to investigate segment-to-segment coronary artery stenosis significance agreement between CCTA, and ICA was performed. Methods In total, 100 patients who underwent CCTA and a diagnostic ICA between June 2021 and December 2021 were prospectively included into this single centre study. For all patients CCTA were performed and for who's with indication for treatment by CCTA, ICA was performed. For all included patients both CCTA and ICA were performed. For coronary artery evaluation 15-segment scheme were chosen in both CCTA and ICA. Coronary arteries were evaluated as follows: right coronary artery (RCA) was divided into 4 segments (S1-S4), left main (S5), left anterior descending (LAD) (S6, S7, S8), first and second diagonals (S9 and S10) and left circumflex (LCx) (S11, S13) and its marginal branches (S12, S14, S15). Segment-to-segment evaluation was performed. The statistical analysis was performed using SPSS 28.0.1.0 statistical analyses package. The chosen level of significance was p<0.05. Results RCA showed following results: S1 (r=−0.02, p=0.87), S2 (r=0.38, p<0.001), S3 (r=0.09, p=0.38) S4 (r=0.30, p=0.002). In LM weak positive correlation was found S5 (r=0.21, p=0.04). In LAD and its diagonal branches following results were found: S6 (r=0.30, p=0.002), S7 (r=0,15, p=0.14), S8 (r=0.28, p=0.004), S9 (r=−0.05, p=0.66), S10 (r=−0.04, p=0.64). Analysis of LCx and its marginal branches revealed S11 (r=0.23, p=0.02), S12 (r=0.22, p=0.03), S13 (r=0.19, p=0.06), S14 (r=0.06, p=0.57), and S15 (r=0.27, p=0.008). Negative non-significant correlations were found in proximal RCA and diagonal branches. That means that in those segments CCTA found more significant lesions, than it was found during ICA. Other segments showed weak positive correlations. The greatest correlations were found in very proximal parts of LAD and LCx. Conclusions The greatest correlations were found in very proximal parts of LAD and LCx in addition to middle RCA segment. Nevertheless, all these correlations were weak. This study failed to show relaible agreement between CCTA and ICA. Funding Acknowledgement Type of funding sources: None.