First experiences with coronary CT angiography in Bajcsy-Zsilinszky Hospital
█ Original article
Czakó Balázs1, Jablonkai Balázs1, Tarján Zsolt2, Andrássy Péter1
1Bajcsy-Zsilinszky Kórház és Rendelőintézet, Kardiológiai Osztály, Budapest
2Bajcsy-Zsilinszky Kórház és Rendelőintézet, Radiológiai Osztály, Budapest
Non-invasive imaging techniques have an increasing role in chronic coronary syndrome assessment. Due to it’s high negative predictive value and low rate of complications, coronary CT angiography is an excellent method for excluding obstructive coronary artery disease and, by recognizing non-significant coronary artery disease, may play a role in the prevention of cardiovascular events. In our hospital coronary CT was initiated in 2018. Since then until the end of 2019, 217 examinations were performed (female: 52%, average age: 56,7±12,7 years), the data of which were analysed retrospectively. The most common indications were chest pain (67%), shortness of breath on exertion (9%) and high cardiovascular risk (8%). The average pre-test probability value was in the lower range (13,5±10,5 %), based on the recent European guideline. Twenty five percent of the patients did not have, 23% had minimal, 21% had mild, 17% had moderate and 14% had severe coronary calcification. CT angiography was not accomplished in 7% of cases due to high degree of coronary calcification. Plaque was found in 58% and obstructive coronary artery disease was found in 24% of the patients. Compared to invasive coronary angiography (which was performed in the clinically reasonable cases), the negative predictive value was consistent with the values in the international literature (in vessel-based analysis 96%, in patient-based analysis 100%).To assess the development, we compared the data of the first 109 patients with the last 108 patients. We found significant reduction in radiation dose, improvement of the image quality and increase in the proportion of prospectively ECG-gated exams. In conclusion, coronary CT angiography, performed in our facility, could be appropriately used for the assessment of chronic coronary syndrome according to international guidelines.