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Prevalence and characteristics of coronary artery disease in a population with suspected ischaemic heart disease using CT coronary angiography: correlations with cardiovascular risk factors and clinical presentation

Prevalenza e caratteristiche della malattia coronarica alla TC in una popolazione con sospetta coronaropatia ischemica: correlazioni con i fattori di rischio cardiovascolari e con la presentazione clinica

  • Cardiac Radiology, Cardioradiologia
  • Published:
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Abstract

Purpose. This study was undertaken to describe the correlation between the distribution of coronary artery disease (CAD) in a symptomatic population with suspected ischaemic heart disease, cardiovascular risk factors (RF) and clinical presentation

Materials and methods. We studied 163 patients (mean age 65.5 years; 101 men and 62 women) referred for multidetector computed tomography coronary angiography (MDCT-CA) to rule out CAD. The patients had no prior history of revascularisation or myocardial infarction. We analysed how the characteristics of CAD (severity and type of plaque) can change with the increase in RF and how they are related to different clinical presentations

Results. Patients were divided into three groups according to the number of RF: zero or one, two or three, and four or more. The percentage of coronary arteries with no plaque, nonsignificant disease and significant disease was 55%, 41% and 4%, respectively, in patients with zero or one RF; 27%, 51% and 22%, respectively, in patients with two or three RF; and 19%, 38% and 44%, respectively, in patients with four or more RF. Plaque in patients with nonsignificant disease was mixed in 65%, soft in 18% and calcified in 17%. The percentage of coronaries with no plaque in the three RF groups was 50%, 20% and 0% in patients with typical chest pain and 46%, 24% and 12% in those with atypical pain. The percentage of significant disease in patients with typical pain was 0%, 47% and 86% and in those with atypical pain 4%, 20% and 29%

Conclusions. MDCT plays an important role in the identification of CAD in patients with suspected ischaemic heart disease. Severity and type of disease is highly correlated with RF number and assumes different characteristics according to clinical presentation

Riassunto

Obiettivo. Descrivere la correlazione esistente tra la distribuzione della patologia coronarica, in una popolazione sintomatica con sospetta cardiopatia ischemica, i fattori di rischio (FDR) cardiovascolari e la presentazione clinica

Materiali e metodi. Abbiamo studiato 163 pazienti (età media 65,5±10,6 anni; 101 maschi e 62 femmine) che hanno eseguito una angiografia coronarica mediante tomografia computerizzata multistrato (TCMS) con lo scopo di escludere la presenza di patologia coronarica; tutti i pazienti erano sintomatici e nessuno aveva storia di rivascolarizzazione o infarto miocardio. Abbiamo analizzato come le caratteristiche della malattia (severità e tipo di placca) possono cambiare con l’aumentare dei FDR e come sono correlate alle differenti presentazioni cliniche

Risultati. Sono stati suddivisi i pazienti in tre gruppi in base al numero dei FDR: con 0 o 1, con 2 o 3 e con 4 o più FDR. La percentuale di coronarie indenni, malattia non significativa e malattia significativa era, rispettivamente, del 55%, 41%, 4% nei pazienti con 0 o 1 FDR, del 27%, 51%, 22% nei pazienti con 2 o 3 FDR e del 19%, 38%, 44% nei pazienti con 4 o più FDR. La placca nei pazienti con malattia non significativa era mista nel 65%, soft nel 18% e calcifica nel 17%. La percentuale di coronarie indenni nei tre gruppi di FDR era 50%, 20%, 0% nei pazienti con dolore tipico e 46%, 24%, 12% in quelli con dolore atipico, mentre la percentuale di malattia significativa nei pazienti con dolore tipico era 0%, 47%, 86% e in quelli con dolore atipico era 4%, 20%, 29%

Conclusioni. La TCMS ha un ruolo importante nella identificazione della patologia coronarica nei pazienti con sospetta cardiopatia ischemica. La severità e il tipo di malattia è fortemente correlato al numero dei FDR e assume caratteristiche differenti in base alla presentazione clinica

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Authors and Affiliations

  1. Dipartimento di Radiologia e Cardiologia, Erasmus Medical Center, Rotterdam, The Netherlands

    F. Cademartiri, A. Palumbo, R. Malagò & N. R. Mollet

  2. Dipartimento di Radiologia e Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Viale Rustici, 23100, Parma, Italy

    F. Cademartiri, M. Romano, S. Seitun, E. Maffei, A. Palumbo, M. Fusaro & A. Aldrovandi

  3. Dipartimento di Radiologia, Università degli Studi di Napoli, Napoli, Italy

    G. Messalli

  4. Dipartimento di Radiologia, Università degli Studi di Milano, Milano, Italy

    S. Tresoldi

  5. Dipartimento di Radiologia, Università degli Studi di Verona, Verona, Italy

    R. Malagò

  6. DIBIMEL, Sezione di Scienze Radiologiche, Università di Palermo, Palermo, Italy

    L. La Grutta, G. Runza & M. Midiri

  7. Unità di Riabilitazione Cardiovascolare, Fondazione Don Gnocchi ONLUS, Parma, Italy

    V. Brambilla

  8. Dipartimento di Cardiologia, Ospedale San Gennaro, Napoli, Italy

    C. Tedeschi

  9. Dipartimento di Cardiologia, Ospedale “Versilia”, Lido di Camaiore, Viareggio, Italy

    G. Casolo

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  1. F. Cademartiri
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  2. M. Romano
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  3. S. Seitun
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  4. E. Maffei
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  8. G. Messalli
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  9. S. Tresoldi
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  10. R. Malagò
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  11. L. La Grutta
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  13. V. Brambilla
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  14. C. Tedeschi
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  15. G. Casolo
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  16. M. Midiri
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  17. N. R. Mollet
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Correspondence to F. Cademartiri.

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Cademartiri, F., Romano, M., Seitun, S. et al. Prevalence and characteristics of coronary artery disease in a population with suspected ischaemic heart disease using CT coronary angiography: correlations with cardiovascular risk factors and clinical presentation. Radiol med 113, 363–372 (2008). https://doi.org/10.1007/s11547-008-0257-6

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  • DOI: https://doi.org/10.1007/s11547-008-0257-6

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