Coronary computed tomography angiography for selecting coronary artery bypass graft surgery candidates

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

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1340-1346
Number of pages7
JournalAnnals of Thoracic Surgery
Volume95
Issue number4
DOIs
Publication statusPublished - 2013 Apr 1

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Coronary Artery Bypass
Transplants
Coronary Artery Disease
Myocardial Revascularization
Multidetector Computed Tomography
Electronic Health Records
Computed Tomography Angiography
Coronary Angiography
Coronary Disease
Cohort Studies
Myocardial Infarction
Confidence Intervals
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Soo Yeon ; Lee, Hye Jeong ; Kim, Young Jin ; Hur, Jin ; Hong, Yoo Jin ; Yoo, Kyung Jong ; Chang, Hyuk Jae ; Kim, Tae Hoon ; Han, Kyung Hwa ; Choi, Byoungwook. / Coronary computed tomography angiography for selecting coronary artery bypass graft surgery candidates. In: Annals of Thoracic Surgery. 2013 ; Vol. 95, No. 4. pp. 1340-1346.
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Coronary computed tomography angiography for selecting coronary artery bypass graft surgery candidates. / Kim, Soo Yeon; Lee, Hye Jeong; Kim, Young Jin; Hur, Jin; Hong, Yoo Jin; Yoo, Kyung Jong; Chang, Hyuk Jae; Kim, Tae Hoon; Han, Kyung Hwa; Choi, Byoungwook.

In: Annals of Thoracic Surgery, Vol. 95, No. 4, 01.04.2013, p. 1340-1346.

Research output: Contribution to journalArticle

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N2 - 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.

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