Coronary Artery Disease. 24(2):135–141, MAR 2013
DOI: 10.1097/MCA.0b013e32835be39a
,
PMID: 23363985
Issn Print: 0954-6928
Publication Date: 2013/03/01
Diagnostic performance of computed tomographic coronary angiography in patients with end-stage renal disease
Borut Jug;Jenny Papazian;Mohit Gupta;Harpreet Bhatia;Arya Derakhshani;Sheri Koplik;Ronald Karlsberg;Matthew Budoff;
+ Author Information
aDivision of Cardiology, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, TorrancebCardiovascular Medical Group of Southern California, Los Angeles, California, USAcPreventive Cardiology Unit, Department of Vascular Diseases, University Medical Center, Ljubljana, Slovenia
Abstract
End-stage renal disease (ESRD) is characterized by a very high rate of cardiovascular events that warrants thorough screening for coronary atherosclerosis, especially in patients undergoing a kidney transplant. Therefore, we assessed the diagnostic performance of 64-slice multidetector coronary computed tomographic angiography (CCTA) in patients with ESRD.We included patients who had been referred for a CCTA and an invasive coronary angiography (diagnostic standard) within 6 months, either as part of clinical work-up in two urban medical centers or as part of the multicenter ACCURACY trial.Thirty-one ESRD patients were included and compared with 588 non-ESRD patients undergoing CCTA and invasive coronary angiography. On a patient-based model, the sensitivity, specificity, and positive and negative predictive values to detect at least 50% and at least 70% stenosis were 100, 78, 92, and 100% and 100, 91, 95, and 100%, respectively, for ESRD patients and 97, 83, 87, and 96% and 94, 87, 85, and 95%, respectively, for non-ESRD controls. There were no statistically significant differences between ESRD and non-ESRD participants in diagnostic performance measures.Results show 64-row multidetector CCTA is highly sensitive and specific in the detection of coronary artery stenosis irrespective of ESRD. Our findings suggest that CCTA is a promising diagnostic tool for the timely detection and/or exclusion of coronary atherosclerosis in patients undergoing pretransplant cardiovascular surveillance.
