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

Authors
 Soo-Yeon Kim  ;  Hye-Jeong Lee  ;  Young Jin Kim  ;  Jin Hur  ;  Yoo Jin Hong  ;  Kyung-Jong Yoo  ;  Hyuk-Jae Chang  ;  Tae Hoon Kim  ;  Kyung-Hwa Han  ;  ByoungWook Choi 
Citation
 Annals of Thoracic Surgery, Vol.95(4) : 1340-1346, 2013 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2013
MeSH
Coronary Angiography/methods* ; Coronary Artery Bypass/methods* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Selection* ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed/methods*
Keywords
Coronary Angiography/methods* ; Coronary Artery Bypass/methods* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Selection* ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed/methods*
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S000349751300088X
DOI
10.1016/j.athoracsur.2013.01.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Han, Kyung Hwa(한경화)
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87073
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