Coronary Angiography For Diagnosis Research Articles

Exploring Lipoprotein-Associated Phospholipase A2 Levels in Iraqi Patients with Stable Angina: Insights from Coronary Angiography Diagnosis

Stable angina is a prevalent heart disease which can be defined as a clinical syndrome of stable coronary artery disease (CAD) that refers to the presence of myocardial ischemia. Lipoprotein-associated Phospholipase A2 (Lp-PLA2) is an important biomarker of atherosclerosis progression through pro-inflammatory and anti-inflammatory effects. Objective: The aim was to detect the role of Lp-PLA2 in the diagnosis of patients with stable angina and normal left ventricular ejection fraction (LVEF). Patients and methods: The study design was a case-control study. 90 males and females (age 40-76 years) who were presented with chest pain were enrolled in the study, all were subjected to echocardiography, ECG and coronary angiography by the cardiologist. Besides, patient’s questionnaire and biochemical analysis were also used. According to the angiography, they were divided into two groups: 60 patients and 30 as a control group. Levels of Lp-PLA2, total cholesterol, triglycerides (TG), high density lipoprotein-Cholesterol (HDL-C), very low density lipoprotein-Cholesterol (VLDL-C) and low density lipoprotein-Cholesterol (LDL-C) in serum were assessed. The biplane M mode method was used to measure left ventricular ejection fraction (LVEF). Result: It was detected that Lp-PLA2 serum levels were significantly higher in the patients than in the control, (P≤0.01). ROC analysis showed that Lp-PLA2 had specificity of 100% and sensitivity 100%. Conclusion: Measurement of Lp-PLA2 can be applied as an excellent biomarker in the diagnosis of patients with stable angina and normal LV ejection fraction.

Incidental Coronary Artery Disease on Routine CT Coronary Angiography –An evidence-based approach

Atherosclerotic coronary artery disease is the leading cause of high morbidity and mortality across the globe [1]. Coronary CT angiography has emerged as a highly accurate non-invasive diagnostic modality for the diagnosis of atherosclerotic coronary artery disease [2]. Coronary CT angiography should be considered as an alternative to stress imaging technique for ruling out atherosclerotic coronary artery disease in patients with the lower range of intermediate pre-test probability for atherosclerotic stable coronary artery disease. However, coronary CT angiography is not recommended as a screening test in asymptomatic individuals without clinical suspicion of coronary artery disease. CT Coronary angiography has been performed routinely before many of the cardiac and non-cardiac procedures like TAVI, atrial fibrillation ablation prior to the organ transplantation. Many a times, advised by Family Physician or patients themselves for a routine screening for atherosclerotic coronary artery disease undergo CT coronary angiography. When incidental atherosclerotic coronary artery disease is found in such patients who do not have any typical or atypical symptom suggestive of coronary artery disease then question arises how to approach this patient as far as the risk estimation for future adverse cardiovascular event and prognostication is concerned. It also becomes imperative to decide the line of management for this patient. To answer these two pertinent questions, we need to understand the behavior and natural history of atherosclerosis & performance of CT coronary angiography in diagnosis and in predicting the prognosis of atherosclerotic disease.

The point-of-care D-dimer test provides a fast and accurate differential diagnosis of Stanford Type A aortic syndrome and ST-elevated myocardial infarction in emergencies

BackgroundThe research of the sensitivity and specificity point-of-care testing (POCT) of D-dimer as a diagnostic protocol for differential diagnosis of Stanford Type A aortic syndrome (hereafter as TAAS) mimicking ST-elevated myocardial infarction (STEMI) with regular STEMI in the emergency department is limited.MethodsFull medical information of 32 patients confirmed TAAS and 527 patients confirmed STEMI from January 1st, 2016 to October 1st, 2021 were retrospectively analyzed in Shanghai Tenth People’s Hospital of Tongji University.ResultsThe baseline characteristics of two groups of patients were well-balanced post propensity score matching (PSM) analysis, and each group had 32 patients enrolled. Patients in the STEMI group had higher positive cardiac troponin I (cTNI) (0.174 ng/ml vs. 0.055 ng/ml, P = 0.008) results but lower D-dimer (0.365μg/ml vs. 31.50μg/ml, P < 0.001) results than the TAAS group. The D-dimer cutoff value of 2.155μg/ml had the best sensitivity of 100% and specificity of 96.9%, and the positive predictive value (PPV) as well as the negative predictive value (NPV) of the cutoff value were 96.9 and 100%, respectively, in total 64 patients, the area under the curve (AUC) values were 0.998 (95% CI:0.992-1.000, P < 0.001) for the D-dimer. No significant correlation between the D-dimer concentration and the time from symptoms onset to first medical contact in both groups (TAAS group: r = − 0.248, P = 0.170; STEMI group: r = − 0.159, P = 0.383) or significant correlation between D-dimer and creatine clearance (TAAS group: r = − 0.065, P = 0.765; STEMI group: r = 0.222, P = 0.221). The total in-hospital mortality for the patients with TAAS presenting as STEMI was 62.5% (20/32). The mortality rate for TAAS patients confirmed by computed tomography angiography (CTA) was significantly lower (40% vs. 82.4%, P = 0.014) than the mortality rate for TAAS patients confirmed by coronary angiography (CAG) and had a longer average survival time (log-rank = 0.015), less peri-surgical complications especially gastrointestinal hemorrhage (0.00% vs. 55.6%, P < 0.001). CTA diagnosis can reduce the mortality rate by 67.5% (95%CI:0.124-0.850, P = 0.16).ConclusionsThe POCT D-dimer with cut-off 2.155μg/ml would be useful to rule-out TAAS mimicking STEMI from regular STEMI prior to reperfusion therapy. CTA diagnosis is effective in reducing the probability of perioperative complications and lowering perioperative mortality than CAG diagnosis in TAAS patients.

The prognostic impact of coronary anatomy in myocardial infarction with nonobstructive coronary artery disease: a seven-year longitudinal follow-up

Abstract Background Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a common condition associated with major adverse events (MAE) that may occur presence of normal or nonobstructive coronary artery anatomy (NCAA and NOCAA, respectively). The prognostic impact presence of NOCAA on long-term outcomes of MINOCA patients remains unclear. Methods This is a retrospective study among consecutive MINOCA patients in a large referral medical center in Israel between the years 2005–2018. Patients with probable alternative cause for myocardial injury, as stress-induced cardiomyopathy and myocarditis, were excluded. Patients were classified according to their coronary angiography diagnosis into NCAA and NOCAA. The primary outcome was MAE, defined as the composite of all-cause mortality and recurrent acute coronary syndrome (ACS). We performed survival analyses using multivariable Cox regression, controlling for potential cofounders. Results Among 36,501 admitted with AMI during the study period, 1,544 patients (4.2%) had MINOCA. Among MINOCA patients, 651 (42%) had NCAA, and 893 (58%) had NOCAA. The mean age was 61.2±12.6 years, and 710 (46.0%) were females. The NOCAA group had more females and were older with higher rates of diabetes, hypertension, dyslipidemia, atrial fibrillation, and chronic renal failure (p&amp;lt;0.05 for all). At a median follow-up of 7 years, MAE occurred in 203 (22.7%) patients and 67 (10.3%) patients in the NOCAA and NCAA groups, respectively (p&amp;lt;0.01). In fully-adjusted multivariable model, NOCAA remained a significant risk factor for long-term MAE [adjusted-hazard-ratio (aHR) 1.67, 95% confidence-interval (95% CI) 1.25–2.23; p&amp;lt;0.001; figure]. Other factors associated with MAE were older age (aHR 1.05, 95% CI 1.03–1.06; p&amp;lt;0.001), left ventricular ejection fraction (LVEF) &amp;lt;40% (aHR 3.04, 95% CI 2.03–4.57; p&amp;lt;0.001) Conclusion Among MINOCA patients, NOCAA was associated with a worse long-term prognosis than NCAA. Other risk factors for long-term MAE were older age and LVEF &amp;lt;40%, while female sex and sinus rhythm at presentation were associated with lower MAE risk. Funding Acknowledgement Type of funding sources: None.

Deep Learning Based Coronary Angiography in Diagnosis of Myocardial Ischemia

Objective. This study was to explore the diagnostic effect of the coronary angiography (CAG) based on the fully convolutional neural network (FCNN) algorithm for patients with coronary heart disease (CHD) and suspected (not diagnosed) myocardial ischemia. Methods. In this study, 150 patients with undiagnosed CHD with myocardial ischemia in hospital were selected as the research objects. They were divided into an observation group and a control group by random number method. The patients in observation group were examined with CAG with the assistance of convolutional neural network (CNN) algorithm, while patients in the control group received conventional CAG. Results. The Dice coefficient of the segmentation effect evaluation index was 0.89, which showed that the image processing effect of the algorithm was good. There was no statistical difference in positive rates of single/double-vessel lesions between the two groups ( P &gt; 0.05 ), and the positive rates of multivessel lesions and total lesions in the observation group were higher than those in the control group, showing statistically obvious difference ( P &lt; 0.05 ). The examination sensitivity, specificity, accuracy, and Kappa value of the observation group were −90.9%, −60%, −82.7%, and −0.72, which were all higher in contrast to those of the control group. The proportion of positive myocardial ischemia and coronary artery stenosis (CAS) (82%) was higher than other cases (18%), and the comparison was statistically significant ( P &lt; 0.05 ). Conclusion. CAG based on the deep learning algorithm showed a good detection effect and can better display the coronary lesions and reflect the good development prospects of deep learning technology in medical imaging.

Diagnostic Value of Spectral CT Reconstruction Mode for Carotid Atherosclerotic Plaque Lesions

Objective: To investigate the diagnostic value of spectral CT reconstruction mode for carotid atherosclerotic plaque lesions. Methods: From January 2017 to January 2019, 70 patients with carotid atherosclerotic plaque lesions in our hospital were selected as the research object. All patients were diagnosed with cervical vascular color Doppler ultrasound and spectral CT scan under spectral CT reconstruction mode. Taking the results of coronary angiography as the “gold standard”, the clinical value of the two examination methods in the diagnosis of carotid atherosclerotic plaque lesions was compared and analyzed. Results: Coronary angiography diagnosis confirmed that 33 of 70 patients with suspected carotid atherosclerotic plaque lesions had vulnerable plaques and 37 had stable plaques. The accuracy of Spectral CT examination of carotid artery plaque was 87.14% (61/70), sensitivity was 90.91% (30/33), specificity was 83.78% (31/37), and the positive predictive value was 83.33% (30 /36), the negative predictive value is 91.76% (31/34), which is higher than that of cervical vascular ultrasonography (61.43%, 60.61%, 56.76%, 57.89%, 65.63%), the difference is statistically significant (P&lt;0.05). Conclusion: The application of Spectral CT in the clinical diagnosis and treatment of carotid atherosclerotic plaque lesions with higher accuracy, sensitivity and specificity, is more significant and can provide a more reliable and effective imaging basis.

Clinical impact of low-radiation computed tomography coronary angiography diagnosis for coronary artery stenosis: Study Protocol.

Background:The objective of this study aims to assess the clinic impact of low-radiation computed tomography coronary angiography (LR-CTCA) diagnosis for coronary artery stenosis (CAS).Methods:This study will comprehensively search the following electronic databases from inception to the present: PUBMED, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, VIP database, WANGFANG, and China National Knowledge Infrastructure. All these electronic databases will be searched without language restrictions. All case-controlled studies on assessing the clinical impact of LR-CTCA diagnosis for patients with CAS will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be utilized to evaluate the methodological quality for each qualified studies.Results:We will assess the clinic impact of LR-CTCA diagnosis for CAS by measuring sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio.Conclusion:The results of this study will summarize the latest evidence of LR-CTCA diagnosis for CAS.Systematic review registration:PROSPERO CRD42019139336.

CT Coronary Angiography versus Coronary Angiography to Detect Specificity and Sensitivity of CT Coronary

Background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive Computed Tomography (CT) coronary angiography are used in the diagnosis of Coronary Artery Disease (CAD). Objective: The present report aims to evaluate the specificity and sensitivity of CT coronary angiography in diagnosis of coronary artery disease compared to the standard invasive coronary angiography. Methods: A retrospective study was done over 2 years started from May of 2015 up to May of 2017. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography and those with CT coronary angiogram. Data on special indications (bypass grafts, in-stent-restenosis) were also included in the evaluation. The CT scanners used with 320 slices. The study included patients with diabetes, hypertension, and data included age, glomerular filtration rate and ejection fraction. Results: Of the 99 patients included in the study, sensitivity of the total lesions were 87.1% which was highest for the graft lesions (100% sensitivity) and lowest for the Left Main (LM) lesions (83.3% sensitivity), on the other hand the specificity of the total lesion were high (98.1% specificity) which also was highest for the graft lesions (100% specificity) and lowest for the Left Anterior Descending (LAD) lesions (95% specificity). Regarding accuracy, CT coronary was 96.6% accurate for the whole lesions. Conclusions: From a medical point of view, CT coronary angiography using scanners with at least 320 slices should be recommended as a test to rule in obstructive coronary stenosis in order to avoid inappropriate invasive coronary angiography in patients with an intermediate pretest probability of CAD. Multi detector CT (MDCT) has reasonably high accuracy for detecting significant obstructive CAD when assessed at artery level.

MSCT Coronary Angiography in Diagnosis of Chronic Coronary Occlusions

MSCT Coronary Angiography in Diagnosis of Chronic Coronary Occlusions

Comparative Study between Multislice Computed Tomography Coronary Angiography and Invasive Coronary Angiography in Diagnosis of Mid and Distal Segment Coronary Artery Stenosis

AbstractBackground: Computed Tomography Coronary Angiog-raphy (CCTA) is a promising method for detection and exclu-sion of obstructive coronary artery stenosis. Mid and distal segments of coronary arteries were chosen because they are usually small in caliber especially distal segment (usually less than 1.5mm) and they are affected by cardiac motion on the contrary, the proximal segment is always away from the myocardium and usually larger in diameter so that it can be easily diagnosed by CCTA.Objective: The purpose of this study was to evaluate the added value of CT coronary angiography for detecting Coro-nary Artery Disease (CAD) in mid and distal segment lesions using invasive coronary angiography as a reference standard.Methods: We prospectively evaluated 20 patients who suspected to have CAD and underwent CTA. we assessed mid and distal segment lesions using invasive coronary angiography as a reference standard. We excluded proximal segment lesion, high calcium score (800), arrhythmias, post percutaneous coronary intervention and post coronary artery bypass graft.Results: A total of 20 subjects underwent both CCTA and ICA (60% were females with mean age: 58.1 years). On a patient based model, the sensitivity, specificity, and positive and negative predictive values to detect mid segment lesions were 88.9%, 95.2%, 88.9%, and 95.2% respectively and for distal lesions were 85%, 100%, 100%, 98.1%, respectively. Diagnosis of mid and distal segment lesions by both CT and coronary angiography showed statistically significant strong positive correlation.Conclusion: CT angiography is a reliable tool and has high accuracy for detection of CAD in both mid and distal segment lesions. Importantly, the high NPV (97%) firmly establishes CCTA as an effective noninvasive method to rule out obstructive coronary artery stenosis in patient with mod-erate pre-test probability.

Spontaneous coronary artery dissection: Acute findings on coronary computed tomography angiography.

The coronary computed tomography angiography features of acute spontaneous coronary artery dissection, an important cause of acute coronary syndrome in young women, have not been assessed. The "Virtual" Multicenter Mayo Clinic Spontaneous Coronary Artery Dissection Registry was established in 2010 and includes retrospective and prospective patient data. Retrospective assessment of acute coronary computed tomography angiography images was performed for 14 patients (16 vessels) who had images performed within two days of invasive coronary angiography diagnosis of acute spontaneous coronary artery dissection. Four pertinent diagnostic coronary features of acute spontaneous coronary artery dissection were observed in order of prevalence: 1) abrupt luminal stenosis (64%); 2) intramural hematoma (50%); 3) tapered luminal stenosis (36%); and 4) dissection (14%). Additional findings include epicardial fat stranding (42%), coronary tortuosity (29%), and coronary bridge (14%). Fifty percent of patients had myocardial hypoperfusion in the myocardial distribution of the dissected coronary artery. We define key coronary computed tomography angiography features of acute spontaneous coronary artery dissection, the most common of which are abrupt luminal stenosis and intramural hematoma. Importantly, intramural hematoma appears similar to noncalcified atherosclerotic plaque, emphasizing the importance of invasive coronary angiography for acute diagnosis of spontaneous coronary artery dissection until the sensitivity and specificity of coronary computed tomography angiography is better understood.

Accident vasculaire cérébral ischémique en rapport avec hématome coronaire spontané

Cardiovascular disease in women is a particularly complex pathology especially in the youngest population. The clinical presentation of acute coronary syndromes is sometimes misleading and does not necessarily point to the potential presence of cardiac disease given the frequent absence of cardiovascular risks. Such complexity results in delayed diagnosis, which worsens the outcome of myocardial infarction and generates complications related to the absence of coronary revascularization. We report the case of a patient who suffered an (undiagnosed) apical myocardial infarction that went undetected and was complicated by a voluminous intraventricular thrombus with embolus migration in the cerebral circulation resulting in an ischemic accident. The combination of these two pathologies make their therapeutic management particularly difficult. As widely reported in the literature, the outcome of myocardial infarction in women is poorer than in their male counterparts for a number of reasons. We can assume that in the youngest patients, another physiopathological mechanism is often involved, namely, the occurrence of hematoma and spontaneous coronary dissection. Diagnosis is often difficult even with coronary angiography diagnosis. As shown in the case reported here, initial examination results, if not thoroughly analyzed, may be erroneously interpreted as normal. It is also likely that the presence of hematoma or coronary wall dissection without any plaque rupture may negatively influence the outcome owing to the implementation of inappropriate treatments. In conclusion, in patients presenting with an ischemic cerebral accident, meticulous cardiac examination must be performed even in young women with no cardiovascular risk factors given that the occurrence of hematoma or coronary dissection may contribute to the formation of mural thrombi in the setting of myocardial infarction. Cardiac MRI seems to be particularly effective in the diagnosis of myocardial infarction complicated by the presence of intracavitary thrombi.

Computed tomography coronary angiography diagnosis of single right coronary artery with congenital absence of left coronary artery system equivalents

The present case report is computed tomography (CT) coronary angiographic depiction of an exceedingly rare entity-single right coronary artery arising from the right sinus of Valsalva with the absence of equivalent left coronary artery system branches and associated mitral valve prolapse. Even though a statistical rarity, it is potentially fatal and can cause myocardial ischemia, sudden cardiac death, and warrants immediate clinical attention. Further, the report reveals the decisive role of CT coronary angiogram in the diagnosis of such rare entities, in contrast to catheter angiography, which may be inconclusive.

Non-Hematopoietic Circulating Progenitor Cells and Presence of Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease

Background: The levels and function of circulating progenitor cells (CPCs) may be affected by chronic metabolic diseases. Aim: To investigate the levels and functions of CPCs in patients with non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD). Methods: In this retrospective study, patients (n=82) undergoing elective coronary angiography for diagnosis of CAD were included. NAFLD was defined as presence of hepatic steatosis by ultrasound in the absence of other causes of liver disease and excessive alcohol use. After coronary angiography, patients were divided into NAFLD with CAD (n=24), NAFLD without CAD (n=13), only CAD (n=31) and Non-NAFLD and Non-CAD (n=14). CPCs were quantified by flow cytometry based on the expression of (CD34+, CD133+, CD34+CD133+) in presence or absence of the hematopoietic marker (CD45). We assessed serum levels of angiogenic growth factors (AGFs) (pg/ml) by Multiplex assay. Results: The levels of the CD45-CD34+ and CD45-CD133+ were higher in NAFLD patients with CAD (median, 15% and 2%, respectively) than NAFLD patients without CAD (median, 9% and 1%, respectively, all p ≤ 0.05). After age adjustment, only CD45-CD34+ circulating progenitor cells remain associated with increased risk of CAD in patients with NAFLD [OR: 8.71 (1.21-62.51)]. In contrast, the levels of the serum vascular endothelial growth factor-C (VEGF-C) was lower in NAFLD patients with CAD (median, 69 pg/ml) than NAFLD without CAD (median, 146 pg/ml) (p=0.01). Conclusions: Our results indicate that high levels of non-hematopoietic CPCs and low levels of AGFs may be associated with increased risk of CAD in NAFLD patients.

GW24-e2455 Analysis of risk factors for patients with essential hypertension combining coronary heart disease

Objectives1) To investigate the characteristics of blood pressure and its relationship with the incidence of cardiovascular event in patients with essential hypertension (EH) combining coronary heart disease (CHD);2) To identify...

Clinical application value of CT coronary angiography in diagnosis for coronary artery heart disease

Objective To investigate the application value of 16-slice spiral CT coronary angiography for clinic coronary artery heart disease treatment.Methods We selected a reasonable set of equipment parameters.60 cases underwent a 16-slice CT cardiac quick scan. Then we reconstructed three-dimensional coronary artery with image post-processing techniques,and observed the coronary artery images to show the location of coronary artery disease,etc. The results were compared with coronary artery angiography.Results In the 658 coronary artery segments (vessel diameter ≥ 2 mm)of 60 patients,559 were judged to be evauable by CT (87％).The scnsitivity and the specificity for the detection of stenosis ≥ 50％ were 87.5％ and 96.5 ％ respectively.When 99 coronary artery segments judged to be unevaluablem were included in the analysis,the sensitivity was 77.7％.Conclusion Coronary angiography of 16-slice spiral CT has high clinical value,it could be used for noninvasive screening and diagnosis for coronary artery heart disease. Key words: Smulti-slice spiral CT; Coronary; Coronary angiography; Three dimension reconstruction

Comparative Analysis between SPECT Myocardial Perfusion Imaging and CT Coronary Angiography for Diagnosis of Coronary Artery Disease

The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

Optical Coherence Tomography and Highly Sensitivity Troponin T for Evaluating Cardiac Allograft Vasculopathy

Cardiac allograft vasculopathy (CAV) is a major impediment to long-term graft survival after heart transplantation. Intravascular ultrasound (IVUS) is more sensitive than coronary angiography for diagnosis, but the identification of specific plaque components or plaque composition is limited. In addition, there is an evident need for other noninvasive tools for diagnosing CAV. The aim of this study was to assess the utility of 2 new techniques for evaluating CAV: optical coherence tomography (OCT), and new high-sensitivity troponin T (hsTnT) assays. In 21 heart transplantation patients, coronary arteriography with IVUS and OCT were performed. Maximal intimal thickness (MIT) and luminal area at the most severe site were measured using the 2 techniques. Immediately before cardiac catheterization, blood samples were obtained and hsTnT levels measured. The evaluation of CAV by OCT showed a good correlation with IVUS measurements, with a mean difference in MIT of 0.0033 (95% confidence interval -0.049 to 0.043), taking advantage of lower interobserver variability (r = 0.94 for OCT vs r = 0.78 for IVUS) and better plaque characterization. When independent predictors of MIT were assessed in a multiple linear regression model, time after transplantation (β = 0.488, p = 0.004) and hsTnT (β = 0.392, p = 0.011) were the only independent predictors of MIT (R(2) = 0.591). In conclusion, this study is the first to evaluate 2 new techniques, OCT and hsTnT, in the challenging setting of CAV. The findings suggest that OCT provides lower interobserver variability and better plaque characterization than IVUS. Also, hsTnT could become a useful tool for ruling out CAV.

How should I treat severe coronary artery calcification when it is not possible to dilate a balloon or deliver a RotaWire™?

Background: A 61-year-old female with a history of type-II (tablet-controlled) diabetes, obesity and dyslipidaemia presented with chest pain and dyspnoea Investigation: Physical examination, electrocardiography, laboratory tests, coronary angiography Diagnosis: Single vessel coronary artery disease with severe calcification of a dominant right coronary artery Treatment: Excimer laser and rotational atherectomy.

MDCT coronary angiography for diagnosis of anomalous origin right coronary artery: a case report

This is a case report of anomalous origin of the right coronary artery, which arises from the left sinus of Valsalva depicted with multi-detector row tomography (MDCT) coronary angiography performed in emergency. In symptomatic patient, this anomalous origin is considered a malignant anomaly and needs urgent surgical treatment. Some studies demonstrated that MDCT is a reliable non-invasive technique to identify and define anomalous coronary arteries (ACAs) and their course.