Multislice CT Coronary Angiography Research Articles

Multi-slice CT coronary angiography versus invasive coronary angiography in the assessment of graft patency after coronary artery bypasses graft surgery

BackgroundThe long-term patency of arterial and venous grafts is crucial for the success of CABG. This study was designed to investigate graft patency using 128-slice coronary computed tomography angiography (CCTA) and compared the results with those obtained using invasive coronary angiography (ICA). In this observational cross-sectional study, we included 40 symptomatic post-CABG patients underwent CCTA and ICA within the same month.ResultsFifty-five percent were aged more than 60 years, and 80% were males. 67.5% had diabetes, 90% had hypertension, and 30% were smokers. Mean body mass index was 28.89 ± 5.17 kg/m2. Mean duration since CABG was 5.25 ± 4.04 years. In total, 124 native vessels and 97 grafts were assessed using CCTA and ICA. CCTA delineated 8 non-cannulated venous grafts and 6 non-cannulated left internal mammary artery grafts. CCTA required a significantly lower radiation dose (1165.77 ± 123.54 vs. 47,589.78 ± 6967.53, p < 0.001).ConclusionCCTA can be as accurate as ICA in assessing bypass grafts with less radiation dose, providing a non-invasive reliable tool for evaluation.

Role of Multi-slice CT Coronary Angiography and Coronary Arteries Calcium Score in Evaluating Patients with Anginal Pain.

Role of Multi-slice CT Coronary Angiography and Coronary Arteries Calcium Score in Evaluating Patients with Anginal Pain.

Multislice CT coronary angiography and coronary artery calcium scoring, correlation with Heart Score

BackgroundCoronary atherosclerosis is the number one leading cause of death. According to estimates, if all primary cardiovascular diseases (CVDs) had been eradicated, life expectancy could increase by nearly seven years. Long asymptomatic latent phases of coronary heart disease allow for early preventive measures. Egypt has a high prevalence of premature Coronary Artery Disease (CAD).Aim of studyWe aimed to evaluate the correlation between the cardiovascular risk assessed by the Systematic COronary Risk Evaluation (HeartScore) and Coronary Artery Calcium Score (CACS) versus the actual extent of atherosclerotic CAD affection among a sample of Egyptian patients assessed by Multislice Computed Tomography (MSCT) due to chest pain complaints.MethodsAn observational cross section study included one hundred studied cases: aged 40 to 69 years old, of which 63% were males, 63% were hypertensive, 39% were diabetic, and 28% were smokers. Those patients presented with symptoms suggestive of coronary artery disease (chest pain). All studied cases had been subjected to history and examination, electrocardiograph (ECG), kidney functions, lipid profile, SCORE calculation, and coronary MSCT scan.ResultsOur observational study found a moderately significant positive relationship between the HeartScore and CACS and CAD; having a higher score carries a higher probability of having CAD. Having a very low score is a good negative test for exclusion. Also, there is a weak relationship between HeartScore, CACS, and the number of diseased coronaries, i.e. these cannot differentiate single vessel disease (SVD) from Multivessel Disease (MVD). In addition, both scores could not determine Obstructive Coronary Artery Disease (OCAD) and Nonobstructive Coronary Artery Disease (Non-OCAD).ConclusionsFrom the clinical point of view, our research suggests that HeartScore and CACS have moderate value in predicting CAD.

Correlation between Impaired Aortic Distensibility and the Severity of Coronary Artery Disease and Calcium Scoring Measured by Cardiac CT

Background: Multi-Slice cardiac CT has evolved as a noninvasive imaging technique for evaluation of stenosis in the coronary arteries by what is called Coronary Computed Tomographic Angiography (CCTA), but it is also widely used in quantitative plaque assessments through Coronary Artery Calcium (CAC) scoring and plaque type identification ( soft or Mixed VS calcific) . Evaluation of aortic distensibility and aortic stiffness can also be performed through Multi-Slice Computed Tomography (MSCT) by calculating Aortic Distensibility Index (ADI) and Pulse Wave Velocity (PWV).&#x0D; Aim: To evaluate whether impaired Aortic Distensibility Index (ADI) and Aortic Stiffness measured by Cardiac CT is correlating with the severity of coronary artery disease and coronary calcium scoring in at-risk individuals (assessed by CCTA).&#x0D; Patients and Methods: We included 180 patients. Patients were classified into four groups according to their CAC score and according to the degree of stenosis based on CCTA. All patients in this study have underwent full history taking, short clinical examination including B.P. and H.R. measurements, standard ECG, routine laboratory investigations, and Multi-Slice CT Coronary Angiography (MSCT-CA).&#x0D; All patients underwent coronary artery calcium (CAC) scanning and CCTA, and their ADI and Aortic Stiffness were measured. Maximum systolic and maximum diastolic cross sectional-area (CSA) of ascending-aorta (AAo) was measured 15-mm above the left main coronary ostium. ADI was defined as: [(Systolic CSA –Diastolic CSA)/ (Diastolic CSA in X systemic-pulse-pressure) X 103]. Aortic stiffness was measured as PWV using Bramwell-Hill equation [1] [(3.57/ √distensibility)].&#x0D; Results: There were strong correlation between Aortic distensibility and Aortic stiffness (PWV) with degree of stenosis and coronary artery calcium.&#x0D; In patients stratified based on the degree of calcium scoring (CAC score), there was a statistically significant negative correlation between calcium scoring and the ADI (Pearson's r= -0.771, p&lt; .001), and a statistically significant positive correlation between calcium scoring and PWV (Pearson's r=0.817, p&lt; .001). &#x0D; In patients stratified based on the degree of stenosis, there was a statistically significant negative correlation between ADI and the Degree of stenosis (Pearson's r=-0.707, p&lt; .001), and there was a statistically significant positive correlation between PWV and the Degree of stenosis (Pearson's r=0.697, p&lt; .001).&#x0D; Conclusion: Impaired aortic distensibility strongly correlates with the severity of coronary atherosclerosis, degree of stenosis and coronary artery calcium. Addition of ADI to CAC and traditional risk factors provides incremental value to predict at-risk individuals.

Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography

AimTo assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. Methods100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. ResultsThe mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=−0.290, p=0.003), coronary Ca score (r=−0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. ConclusionIn addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.

Correlation of coronary artery geometry with the complexity and severity of coronary atherosclerosis: rationale and design of the GEOMETRY-CTA study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research is co-financed by Greece and the European Union (European Social Fund-ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Correlation of coronary artery tree geometry and clinical parameters with the distribution, complexity and severity of coronary artery disease: a pilot study using multislice CT coronary angiography” (MIS 5047882) Background Development and progression of coronary atherosclerosis is complex and not yet fully understood. Accumulative evidence supports the notion that coronary artery disease (CAD) results from an interaction of systemic factors, such as dyslipidemia, with local hemodynamic factors that regulate the site-specific predilection of atherosclerosis, particularly low endothelial shear stress (ESS). Since low ESS develops in geometrically irregular regions of the coronary tree for a given arterial blood flow, geometrical factors affect atherosclerotic plaque distribution and vulnerability. However, the correlation of coronary geometric features with the complexity and severity of CAD has not been fully elucidated. Purpose GEOMETRY-CTA is a prospective, non-randomized, observational study that aims to investigate the correlation of coronary artery geometrical features with the complexity and severity of CAD using Coronary Computed Tomography Angiography (CCTA). The prognostic value of a CCTA-derived geometric risk score will also be assessed. Methods The study aims to recruit 100 consecutive patients with suspected CAD and low/intermediate pre-test probability. Coronary geometrical characteristics such as angulation of coronary bifurcations, tortuosity, coronary artery volume index (CAVi) and vessel-length will be assessed with multi-planar reformation and volume rendering techniques, and integrated into a single geometric risk score. The extent and vulnerability of plaque burden will be calculated using several anatomical scoring systems such as the Leiden CTA risk score, CT-SYNTAX score, and CT-adapted Gensini score. Patients will be prospectively followed for 12 months after enrollment. Results The primary objective of the study is to evaluate the correlation of the geometric risk score with CAD severity and plaque vulnerability. We also hypothesize that wider bifurcation angles and lower CAVi augmenting the atherosclerosis-prone environment and predict higher CAD extent and complexity. Conclusion The present study aims to introduce a quantitative, non-invasive imaging biomarker expressing CAD severity and investigate its prognostic value in regards to adverse cardiovascular events. The derived index will be available for incorporation in larger national prospective studies for further cardiovascular risk stratification.

The Complementary Relationship Between Echocardiography and Multi-Slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Artery Thrombosis in Children With Kawasaki Disease.

Aim: To compare the diagnostic values by using transthoracic echocardiography (ECHO) and multi-slice spiral CT coronary angiography (CTCA) for identifying coronary artery thrombosis in children with Kawasaki disease (KD).Methods: Total 97 KD children with coronary artery dilation complications in our hospital from June 2012 to December 2020 were included in the study. CTCA and ECHO were performed after over 1 month of illness.Results: Coronary artery thrombosis was found in 14 out of 97 patients. Among them, 10 were identified as positive by CTCA, 9 were identified as positive by ECHO, and 5 were identified as positive by both CTCA and ECHO.Conclusion: Both CTCA and ECHO can be used to diagnose coronary artery thrombosis. ECHO has advantage in identifying low-density thrombus, and CTCA is better for the clot in distal coronary artery. They can complement each other.

Relationship of serum vitamin D deficiency with coronary artery disease severity using multislice CT coronary angiography

AimTo assess the relationship between vitamin D deficiency and severity of coronary artery disease using multislice CT coronary angiography. Methods100 patients diagnosed with coronary artery disease during multislice CT coronary angiography were subjected to full evaluation of coronary artery disease severity followed by measurement of serum vitamin D level. ResultsThe mean value of serum vitamin D level was 13.35±7.49ng/ml. 76% of the patients had vitamin D deficiency (<20ng/ml). 41% of the patients had single vessel disease, 28% had two vessel diseases, and 31% had multi-vessel disease. Patients with vitamin D deficiency had higher degree of coronary stenosis, higher coronary Ca score (p<0.001) and higher number of affected vessels compared with normal vitamin D level subgroup (p<0.001). Vitamin D level showed a significant negative correlations with age (r=−0.290, p=0.003), coronary Ca score (r=−0.630, p<0.001) and severity of coronary lesions. Multivariate linear regression analysis showed that dyslipidemia and vitamin D level were independent predictors of percent severity of coronary stenosis. ConclusionIn addition to traditional cardiovascular risk factors, vitamin D deficiency looks to be independent predictor of coronary artery disease severity including percent stenosis, number of the affected vessels as well as degree of coronary calcification.

EFFECT OF DIABETES MELLITUS ON GRAFT DISEASE PATTERN AFTER CORONARY ARTERY BYPASS GRAFT SURGERY IN SYMPTOMATIC PATIENTS DETECTED BY MULTI SLICE CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY

ABSTRACT Background: Surgical revascularization of the coronary arteries is one of the most frequent surgical procedures performed worldwide. Although the procedure is one of the major successes of modern medicine, it does not treat the disease underlying the symptoms (atherosclerosis), but only the clinical presentation of coronary artery disease. Multi detector computed tomography (MDCT) accuracy in coronary artery bypass grafting (CABG) patency and stenosis assessment is excellent compared with angiography. Its safety advantages have led to rapidly increasing usage in both native and grafted vessel evaluation. Objective: To evaluate the impact of diabetes mellitus on the patency of arterial and venous grafts after coronary artery bypass surgery assessed by multi slice CT coronary angiography. Patients and methods: One hundred post CABG patients were included, and divided into two groups: Group A (sixty diabetic patients) from which thirty two had NIDDM (53.3% of diabetic patients), twenty eight (46.6% of diabetic patients) had IDDM, and group B (forty non diabetic patients). Patients subjected to our study were symptomatic with recurrent typical chest pain or angina equivalent. All included patients had sinus rhythm, heart rate less than 70 bpm, weight less than 150 kg and serum creatinine <1.5 mg/dl. Patients were investigated by Seimens Somatom Definition Flash 64- dual source MDCT at least 12 months after the surgery. Results: The most common risk factor in our studied population was hypertension affecting 55% of studied population followed by smoking which was prevalent at 54% of studied population. Comparison of the number of diseased grafts in the two study groups according to hypertension showed a statistically significant difference in group A (diabetic group). Comparison of the number of diseased grafts in the two study groups according to dyslipidemia showed a statistically significant difference in group A. Comparison of the number of diseased grafts in the two study groups according to smoking showed a statistically significant difference in group B (non- diabetic group). 101 arterial grafts had been evaluated for patency, 96 LIMA and 5 radial arteries. There were 59 LIMA in diabetic patients and 37 LIMA in non-diabetic patients evaluated. There was no statistically significant LIMA occlusion in group A and group B. In our study, 141 venous grafts were evaluated for patency: 83 venous grafts in diabetic patients, and 58 venous grafts in non-diabetic patients. Comparison of the two study groups as regards patency of venous grafts showed a statistically significant in group A , and revealed also more occluded grafts at diabetic group. There was a statistically significant graft occlusion with longer duration of diabetes mellitus and higher glycosylated hemoglobin HbA1c. Conclusion: Multi-slice CT coronary angiography has an important role in evaluation patency of coronary grafts after coronary artery bypass surgery. Graft occlusions were more common among diabetics compared with non-diabetics. Diabetes was associated with lower vein graft patency but similar arterial graft patency in comparison to non-diabetics. Uncontrolled diabetes mellitus and long duration of disease was found to be a significant predictor for graft occlusion.

Long-term follow-up of therapeutic efficacy of everolimus-eluting bioresorbable vascular scaffold in comparison to everolimus-eluting stent in treatment of chronic total occlusion guided by intracoronary imaging

BackgroundWe hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging.Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period.ResultsAt 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476).No differences were found at angiographic or clinical follow-up between BVS and EES.ConclusionThis study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology.Trial registrationZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: IRB_123@medicine.zu.edu.eg

Value of Multi-Slice CT Coronary Angiography in Assessment of Remodeling Index in Low to Intermediate Risk Chronic Stable Angina Patients

Value of Multi-Slice CT Coronary Angiography in Assessment of Remodeling Index in Low to Intermediate Risk Chronic Stable Angina Patients

Role of multidetector CT Coronary Angiography in Assessment of the prevalence and plaque composition between dyslipidemic and non dyslipidemic patients

Abstract Purpose To highlight the role of multislice CT coronary angiography with its new applications such as reformatted images, and high resolution imaging, regarding coronary plaque composition and prevalence in dyslipidemic and non dyslipidemic patients Methods The study included 30 patients, 15 non dyslipidemic and 15 dyslipidemic patients. Each patient included in the study was subjected to full history taking, reviewing medical sheet. CTCA was performed for all patients followed by analysis of the plaque composition and percent stenosis using the axial images and multiplanar reconstruction. Results It was found that dyslipidemic patients had more plaque burden than non dyslipidemic. The dyslipidemic patients were more liable for multiple and soft plaques, mainly appreciated at the distal segment of the coronary arteries while non dyslipidemic were more liable for single and calcific/mixed plaques. Thus, may encourage the clinician to use lipid lower drugs as primary or secondary intervention for CAD.

Detection of positively remodeled coronary artery lesions by multislice CT and its impact on cardiovascular future events

BackgroundPositive arterial remodeling may be a characteristic of early proliferative lesions. The study was done to identify the different morphological characteristics of the positively remodeled coronary lesions, and causing non-significant arterial stenosis, as detected by multislice computed tomography coronary angiography (MSCT CA) and its predictors of cardiovascular clinical events at 90-day follow-up. The study included 55 patients who were candidate for MSCT CA and found to have a single-vessel disease with less than 70% stenosis positively remodeled lesions. The most expansive or solitary lesion was selected for each patient. Positive remodeling defined as remodeling index (RI) > 1.05. We followed the patients clinically for 90 days.ResultsTwenty-four patients had a history of acute coronary syndrome at initial presentation with normal LV systolic function for all studied patients. Dyslipidemia was found in 37 patients (67.3%) while diabetes was found in 29 patients (52.7%). The majority of the lesions were found in the proximal LAD (43.6%). The mean calculated remodeling index was 1.41 ± 0.25. At the end of 90 days, 25 patients had clinical events in the form of unstable coronary syndromes, coronary interventions, or coronary angiography related to the index lesion. The predictors of clinical events were duration of DM, higher degree of luminal narrowing, calculated wall/lumen area percentage, plaque burden, plaque-specific calcification, and total calcium score at remodeling site as well as a lower percentage of low-attenuation plaque area. The mean calculated wall/lumen area percentage was 263.72 ± 122.71%. A cut-off value of > 226% was found a predictor for clinical events. The mean plaque burden percentage was 69.72 ± 9.71%, a value of > 69% was found a predictor for clinical events. Both values had a sensitivity of 68% and specificity of 86.6% and PPV of 81%. Positively remodeled lesions with a high RI > 1.4 were correlated with patients who had acute coronary syndrome on their initial presentation.ConclusionDifferent morphological characteristics of positively remodeled non-occlusive atherosclerotic plaques as detected by multislice CT coronary angiography may be good potential predictors of future cardiovascular events.

Association of Significant Coronary Arterial Disease, Coronary Calcification and Carotid Intima Media Thickness with Glycosylated Hemoglobin Levels in Patients without History of Diabetes Mellitus Sent for Coronary CT Angiography

Background: Diabetes mellitus (DM) is a risk factor for the development of the coronary heart disease (CHD), and individuals with DM have more extensive atherosclerosis, more cardiac events, and higher prevalence of silent ischemia as compared with individuals without DM. Objective: The aim of the study is to assess the association of significant coronary arterial disease, coronary calcification and carotid intima media thickness with glycosylated hemoglobin levels in patients without history of diabetes mellitus sent for coronary CT angiography. Patients and methods: This prospective study included 39 patients who underwent 320 Multi-slice CT coronary angiography (Aquilion ONE 320 MSCT) at (Nasr-City Police Hospital) through the period from May 2017 to April 2018. They divided into 3 equal groups according to HbA1c (G1, non-diabetic, G2, pre-diabetic and G3 diabetic). The study was approved by Ain Shams University academic and ethical committee and an informed written consent was obtained from all patients. Results: At level of multi-slice CT coronary, CCS was significantly higher in Group C than in Group A and B. But no significant difference could be picked in subgroup analysis between Group A and Group B. There were no significant differences among groups as regarding significant coronary artery stenosis. But there was a trend towards significance in Group C; however, it failed to reach significance mostly because of the small sample size. At level of carotid Doppler US, there were significant differences between groups as regarding bilateral CIMT. But this significance was mainly between Group C and the other groups in subgroup analysis. As regarding correlation, age and HbAlc had a positive strong correlation with CCS, LT CIMT, and RT CIMT. Conclusion: HbAlc positively correlates with coronary and carotid atherosclerosis and patients with mild elevation of HbAlc has significantly more CIMT than individuals with normal HbAlc.

Association of Significant Coronary Arterial Disease, Coronary Calcification and Carotid Intima Media Thickness with Glycosylated Hemoglobin Levels in Patients without History of Diabetes Mellitus Sent for Coronary CT Angiography

Background: Diabetes mellitus (DM) is a risk factor for the development of the coronary heart disease (CHD), and individuals with DM have more extensive atherosclerosis, more cardiac events, and higher prevalence of silent ischemia as compared with individuals without DM. Objective: The aim of the study is to assess the association of significant coronary arterial disease, coronary calcification and carotid intima media thickness with glycosylated hemoglobin levels in patients without history of diabetes mellitus sent for coronary CT angiography. Patients and methods: This prospective study included 39 patients who underwent 320 Multi-slice CT coronary angiography (Aquilion ONE 320 MSCT) at (Nasr-City Police Hospital) through the period from May 2017 to April 2018. They divided into 3 equal groups according to HbA1c (G1, non-diabetic, G2, pre-diabetic and G3 diabetic). The study was approved by Ain Shams University academic and ethical committee and an informed written consent was obtained from all patients. Results: At level of multi-slice CT coronary, CCS was significantly higher in Group C than in Group A and B. But no significant difference could be picked in subgroup analysis between Group A and Group B. There were no significant differences among groups as regarding significant coronary artery stenosis. But there was a trend towards significance in Group C; however, it failed to reach significance mostly because of the small sample size. At level of carotid Doppler US, there were significant differences between groups as regarding bilateral CIMT. But this significance was mainly between Group C and the other groups in subgroup analysis. As regarding correlation, age and HbAlc had a positive strong correlation with CCS, LT CIMT, and RT CIMT. Conclusion: HbAlc positively correlates with coronary and carotid atherosclerosis and patients with mild elevation of HbAlc has significantly more CIMT than individuals with normal HbAlc.

Multi-slice CT coronary angiography assessment of remodeling index in patients with low- to intermediate-risk stable angina

BackgroundEarly identification of vulnerable plaques by remodeling index prior to rupture and development of acute event is of considerable importance especially by a reliable non-invasive method as CT coronary angiography (CTA), so we aim to evaluate coronary artery remodeling index in patients with low- to intermediate-risk stable angina by CTA.ResultsThis single-center, cross-sectional, observational study included 150 patients with stable angina with normal resting ECG, negative markers, normal systolic function by 2D echocardiography (EF > 50%), and without regional wall motion abnormality at rest who were referred to MSCT evaluation of the coronary artery tree; the mean age was 56.8 ± 6.4 years, 83.3% had one-vessel disease, and 16.7% had two-vessel diseases. The mean remodeling index (RI) was 1.04 ± 0.28, 38% had significant positive remodeling, LAD was the most affected vessel (55.3), and proximal lesions were predominant in 48.5%; there was a statistically significant positive correlation between RI and cholesterol, triglyceride, LDL, duration of DM, HBA1c, and plaque burden (P < 0.001) and a statistically significant negative correlation with HDL (P < 0.001). Predictors of higher RI were positive family history, diabetes mellitus, low HDL, HBA1c, and plaque burden% (P < 0.001). Patients with remodeling index > 1.1 were diabetic, hypertensive, smoker, with longer duration of diabetes mellitus, higher HBA1c, cholesterol, triglyceride, LDL, plaque burden, wall lumen ratio, stenosis area, and lower HDL.ConclusionCTA was able to detect the presence and extent of early, non-obstructive but significant coronary artery-positive remodeling in patients with low- to intermediate-risk stable angina patients.Trial registrationNCT03963609, 22 May 2019

QUANTITATIVE CORONARY PLAQUE CHARACTERIZATION WITH MULTIDETECTOR CT ANGIOGRAPHY

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality. Coronary atherosclerosis is a progressive disease with sudden destabilizing changes leading to plaque thrombosis and reorganization. Aim of work: Quantitatively characterize coronary atherosclerotic plaque composition in patients with CAD referred to Ain shams radiology department (El Demerdash Hospital) by using CT coronary angiography and compare prevalence of different plaque types. Patients and Methods: Seventy-eight patients of CAD symptoms (49 male, 29 female; mean age, 54.8 years) underwent CT coronary angiography (CTCA). Each patient underwent a non-contrast scan to determine the calcium score, then a contrast enhanced ECG gated scan. Coronary plaques were analysed as regard number, type, severity and plaque volumes by using semiautomated software. Results: 14 patients had normal CTCA, 37 patient had significantobstructive lesions, and 4 of them had a totally occluded coronary vessel. A total of 232 coronary vessel plaques were found. The number of patients with multi-vessel disease was significantly higher in diabetic patients verses non diabetics. Noncalcified plaques were more prevalent (than calcified plaques), in patients 55 years only 39.3% of their plaques were noncalcified. Conclusion: Multi-slice CTCA is the non-invasive alternative to intravascular ultrasonography (IVUS) for plaque quantification, it is a reliable technique to detect CAD and estimate the degree of obstruction, number of affected vessels and the pattern of theiraffection. Using automated software provide the major advantage of higher reproducibility.

Multi-slice CT Coronary Angiography in Patients With Stable Angina

Multi-slice CT Coronary Angiography in Patients With Stable Angina

Coronary Stent Patency and In-Stent Restenosis in Patients referred To Multislice CT Coronary Angiography

Coronary Stent Patency and In-Stent Restenosis in Patients referred To Multislice CT Coronary Angiography

The Relation between Red Cell Distribution Width (RDW) and Coronary Artery Calcium Score(CACS) in the Diabetic Patients Undergoing Coronary CT Angiography

Background: red cell distribution width is a marker associated with increased mortality and morbidity in cardiac patients, however it’s relation with coronary artery calcium score (CACS) is not well studied yet. Aim of the work: this study aimed to assess the relation between red cell distribution width (RDW) and coronary artery calcium score (CACS) in the diabetic patients undergoing coronary CT angiography. Patients and methods: this study was conducted on 60 patients presented for assessment of coronary artery disease (CAD) by coronary CT angiography and they were categorized into 2 groups, group (A) diabetics(30 patients),group(B)non-diabetics (30 patients), All patients included in this study were subjected to: History Taking, complete physical examination, multi-slice CT coronary angiography (MSCT) including calcium score(CACS), laboratory investigations including complete blood count (CBC) including RDW(SD&CV), serum calcium level(total and ionized), erythrocyte sedimentation rate (ESR), lipid profile. Results: higher RDW(SD) was associated with the presence of greater coronary complexity of CAD and higher calcium score. In our study total serum calcium and RDW (SD) were found to be independent predictors of high Ca score more than 100, while ionized calcium and systolic blood pressure(SBP) were independent predictors of high Calcium score more than 400. Cut off value of RDW to predict high calcium score (more than 100) was RDW(CV) more than 13.45 & RDW(SD) more than44.45, while Cut off value of RDW to predict high calcium score (more than 400) was RDW(SD) more than 45.1. Conclusions: a greater baseline RDW(SD) value was independently associated with the presence of a greater coronary complexity of CAD and higher calcium score.