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Development and Validation of a Predictive Screening Tool for Uninterpretable Coronary CT Angiography Results.
MedLine Citation:
PMID:  21775504     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Coronary CT angiography (CCTA) is an excellent tool for noninvasive assessment of coronary arteries in low-to-intermediate risk individuals. However, the accuracy of CCTA is heavily dependent on image quality. Our objective was to develop and validate a tool to predict pre-CCTA risk of obtaining an uninterpretable result in symptomatic patients. METHODS AND RESULTS: -Among 8,585 symptomatic patients, we identified variables independently associated with the presence of at least one uninterpretable major coronary segment to create the uninterpretable risk score (URS). This risk score was developed using both clinical variables and patient variables acquired at the time the CCTA was performed (heart rate and coronary calcium). The URS was then prospectively validated among an additional 915 symptomatic patients. The URS was predictive of uninterpretable results in both the development and validation cohorts. For every 4-point increase in the URS (range 0 to 12), the rate of at least one uninterpretable coronary segment per 100 CCTA studies increased ~1.5 fold. Increased heart rate and calcium artery score were predictive of uninterpretable CCTA study results. Uninterpretable results were associated with 3-month outcomes in the development cohort. CONCLUSIONS: -The URS can categorize patients who are likely to have at least one uninterpretable major coronary segment on CCTA. This may aid in appropriate patient selection for CCTA and avoiding radiation exposure in those likely to have an uninterpretable study. Clinical Trial Registration-URL: http:///www.clinicaltrials.gov. Unique Identifier: NCT00640068.
Authors:
Thomas E Vanhecke; Ryan D Madder; James E Weber; Lawrence F Bielak; Patricia A Peyser; Kavitha M Chinnaiyan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-20
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Genesys Regional Medical Center/Ascension Health, Grand Blanc, MI;
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