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Coronary Computed Tomography Angiography for Selecting Coronary Artery Bypass Graft Surgery Candidates

Authors
 Soo-Yeon Kim ; Hye-Jeong Lee ; ByoungWook Choi ; Kyung-Hwa Han ; Tae Hoon Kim ; Hyuk-Jae Chang ; Kyung-Jong Yoo ; Yoo Jin Hong ; Jin Hur ; Young Jin Kim 
Citation
 Annals of Thoracic Surgery, Vol.95(4) : 1340~1346, 2013 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2013
Abstract
BACKGROUND: There have been limited reports on the diagnostic performance and prognostic value of coronary computed tomography angiography (CCTA) for selecting coronary artery bypass graft (CABG) candidates. METHODS: There were 1,018 patients with suspected coronary artery disease who underwent 64-slice multidetector CCTA between July 2009 and January 2010. Of them, we excluded 324 patients who denied further treatment (n=7), who were lost for unidentified reasons (n=107), or who were transferred to local clinics (n=210). The total analysis cohort consisted of 694 patients. We established eligible CABG criteria defined as three-vessel disease, left main coronary disease, and left main coronary artery equivalent disease. Diagnostic performance was determined using conventional coronary angiography as the reference standard. For assessment of the prognostic utility of CCTA, electronic medical records were reviewed to screen for the occurrence of a major adverse cardiac event, defined as cardiac death, nonfatal myocardial infarction, or revascularization. RESULTS: The overall sensitivity, specificity, positive predictive value, and negative predictive value of CCTA for the selection of CABG candidates were 83.3%, 96.2%, 90.9%, and 92.7%, respectively. The presence of CABG criteria on CCTA was an independent prognostic factor for predicting a major adverse cardiac event (hazard ratio, 12.508; 95% confidence interval, 7.353 to 21.278; p<0.0001). CONCLUSIONS: We found CCTA had a high diagnostic performance for selecting CABG candidates and predicted major adverse cardiac events in CABG candidates referred for CCTA owing to suspected coronary artery disease.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87073
DOI
10.1016/j.athoracsur.2013.01.004
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Thoracic & Cardiovascular Surgery
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
1. 연구논문 > 1. College of Medicine > Yonsei Biomedical Research Center
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S000349751300088X
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