Diagnostic accuracy of 64-slice MDCT coronary angiography for the assessment of coronary artery disease in Korean patients with type 2 diabetes

Title
Diagnostic accuracy of 64-slice MDCT coronary angiography for the assessment of coronary artery disease in Korean patients with type 2 diabetes
Author(s)
이형우문준성원규장조인호윤지성
Keywords
iodixanol; isosorbide dinitrate; metoprolol; unclassified drug; visisense; adult; angiocardiography; article; cardiac imaging; computed tomographic angiography; computed tomography scanner; controlled study; coronary artery calcium score; coronary artery disease; coronary artery obstruction; data analysis software; diagnostic accuracy; diagnostic test accuracy study; female; human; image quality; major clinical study; male; multidetector computed tomography; neuromodulation; non insulin dependent diabetes mellitus; non invasive procedure; predictive value; sensitivity and specificity; single drug dose
Issue Date
201302
Citation
Diabetes and Metabolism Journal, v.37, no.1, pp.54 - 62
Abstract
Background: A 64-slice multidetector computed tomography (MDCT) is well known to be a useful noninvasive form of angiography for the general population, but not for certain patients with diabetes. The aim of this study was to investigate the diagnostic accuracy and usefulness of 64-slice MDCT coronary angiography for detecting coronary artery disease in Korean patients with type 2 diabetes mellitus (T2DM). Methods: A total of 240 patients were included, 74 of whom had type 2 diabetes (M:F=40:33; 41.8��9.5 years). We compared significant coronary stenosis (>50% luminal narrowing) in MDCT with invasive coronary angiography (ICA) by segment, artery, and patient. We also evaluated the influence of obesity and coronary calcium score on MDCT accuracy. Results: Of the 4,064 coronary segments studied, 4,062 segments (T2DM=1,109) were assessed quantitatively by both MDCT and ICA, and 706 segments (T2DM=226) were detected as a significant lesion by ICA in all patients. Sensitivity, specificity, as well as positive and negative predictive values for the presence of significant stenosis in T2DM were: by segment, 89.4%, 96.4%, 85.8%, and 97.4%, respectively; by artery (n=222), 95.1%, 92.9%, 94.4%, and 93.8%, respectively; by patients (n=74), 98.4%, 100.0%, 98.4%, and 90.0%, respectively. Regardless of presence of diabetes, there was no significant difference in diagnostic accuracy. Obesity (��25kg/m2) and coronary calcium score did not also affect the diagnostic accuracy of MDCT. Conclusion: The 64-slice MDCT coronary angiography was found to have similar diagnostic accuracy with ICA, regardless of diabetes. These results suggest MDCT may be helpful to reduce unnecessary invasive studies for patients with diabetes. ? 2013 Korean Diabetes Association.
URI
http://hdl.handle.net/YU.REPOSITORY/26390http://dx.doi.org/10.4093/dmj.2013.37.1.54
ISSN
2233-6079
Appears in Collections:
의과대학 > 내과학교실 > Articles
의과대학 > 영상의학과학교실 > Articles
의과대학 > 핵의학교실 > Articles
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