Abstract
Background: The aims of this study are to evaluate the accuracy of low dose multidetector computed tomography coronary angiography (MDCT) versus invasive coronary angiography (ICA) in ruling out CAD in patients with mitral valve prolapse and severe mitral regurgitation (MVP) before cardiac surgery and to compare the overall effective radiation dose (ED) and cost of a diagnostic approach in which conventional ICA should be performed only in patients with significant CAD as detected by MDCT. Methods: Eighty patients with MVP and without history of CAD were randomized to MDCT (Group 1) or ICA (Group 2) to rule out CAD before surgery. However, ICA was also performed as gold standard reference in Group 1 to test the diagnostic accuracy of MDCT. A diagnostic work-up A in whom all patients underwent low-dose MDCT as initial diagnostic test and those with positive findings were referred for ICA was compared with work-up B in which all patients were referred for ICA according to the standard of care in terms of ED and cost. Results: The two groups were homogeneous in terms of gender, age and body mass index. The overall feasibility and accuracy in a patient-based model were 99% and 93%, respectively. The overall ED and costs were significantly lower in diagnostic work-up A compared to diagnostic work-up B. Conclusions: The accuracy of low dose MDCT for ruling out the presence of significant CAD in patients undergoing elective valve surgery for mitral valve prolapse is excellent with a reduction of overall radiation dose exposure and costs.
| Original language | English |
|---|---|
| Pages (from-to) | 2889-2894 |
| Number of pages | 6 |
| Journal | International Journal of Cardiology |
| Volume | 167 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2013 |
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Keywords
- Accuracy
- Coronary artery disease
- Cost-Effectiveness
- Invasive coronary angiography
- MDCT
- Mitral valve prolapse
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Pre-operative CT coronary angiography in patients with mitral valve prolapse referred for surgical repair : Comparison of accuracy, radiation dose and cost versus invasive coronary angiography. / Pontone, Gianluca; Andreini, Daniele; Bertella, Erika; Cortinovis, Sarah; Mushtaq, Saima; Foti, Claudia; Annoni, Andrea; Formenti, Alberto; Baggiano, Andrea; Conte, Edoardo; Ballerini, Giovanni; Fiorentini, Cesare; Bartorelli, Antonio L.; Pepi, Mauro.
In: International Journal of Cardiology, Vol. 167, No. 6, 2013, p. 2889-2894.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pre-operative CT coronary angiography in patients with mitral valve prolapse referred for surgical repair
T2 - Comparison of accuracy, radiation dose and cost versus invasive coronary angiography
AU - Pontone, Gianluca
AU - Andreini, Daniele
AU - Bertella, Erika
AU - Cortinovis, Sarah
AU - Mushtaq, Saima
AU - Foti, Claudia
AU - Annoni, Andrea
AU - Formenti, Alberto
AU - Baggiano, Andrea
AU - Conte, Edoardo
AU - Ballerini, Giovanni
AU - Fiorentini, Cesare
AU - Bartorelli, Antonio L.
AU - Pepi, Mauro
PY - 2013
Y1 - 2013
N2 - Background: The aims of this study are to evaluate the accuracy of low dose multidetector computed tomography coronary angiography (MDCT) versus invasive coronary angiography (ICA) in ruling out CAD in patients with mitral valve prolapse and severe mitral regurgitation (MVP) before cardiac surgery and to compare the overall effective radiation dose (ED) and cost of a diagnostic approach in which conventional ICA should be performed only in patients with significant CAD as detected by MDCT. Methods: Eighty patients with MVP and without history of CAD were randomized to MDCT (Group 1) or ICA (Group 2) to rule out CAD before surgery. However, ICA was also performed as gold standard reference in Group 1 to test the diagnostic accuracy of MDCT. A diagnostic work-up A in whom all patients underwent low-dose MDCT as initial diagnostic test and those with positive findings were referred for ICA was compared with work-up B in which all patients were referred for ICA according to the standard of care in terms of ED and cost. Results: The two groups were homogeneous in terms of gender, age and body mass index. The overall feasibility and accuracy in a patient-based model were 99% and 93%, respectively. The overall ED and costs were significantly lower in diagnostic work-up A compared to diagnostic work-up B. Conclusions: The accuracy of low dose MDCT for ruling out the presence of significant CAD in patients undergoing elective valve surgery for mitral valve prolapse is excellent with a reduction of overall radiation dose exposure and costs.
AB - Background: The aims of this study are to evaluate the accuracy of low dose multidetector computed tomography coronary angiography (MDCT) versus invasive coronary angiography (ICA) in ruling out CAD in patients with mitral valve prolapse and severe mitral regurgitation (MVP) before cardiac surgery and to compare the overall effective radiation dose (ED) and cost of a diagnostic approach in which conventional ICA should be performed only in patients with significant CAD as detected by MDCT. Methods: Eighty patients with MVP and without history of CAD were randomized to MDCT (Group 1) or ICA (Group 2) to rule out CAD before surgery. However, ICA was also performed as gold standard reference in Group 1 to test the diagnostic accuracy of MDCT. A diagnostic work-up A in whom all patients underwent low-dose MDCT as initial diagnostic test and those with positive findings were referred for ICA was compared with work-up B in which all patients were referred for ICA according to the standard of care in terms of ED and cost. Results: The two groups were homogeneous in terms of gender, age and body mass index. The overall feasibility and accuracy in a patient-based model were 99% and 93%, respectively. The overall ED and costs were significantly lower in diagnostic work-up A compared to diagnostic work-up B. Conclusions: The accuracy of low dose MDCT for ruling out the presence of significant CAD in patients undergoing elective valve surgery for mitral valve prolapse is excellent with a reduction of overall radiation dose exposure and costs.
KW - Accuracy
KW - Coronary artery disease
KW - Cost-Effectiveness
KW - Invasive coronary angiography
KW - MDCT
KW - Mitral valve prolapse
UR - http://www.scopus.com/inward/record.url?scp=84883825104&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883825104&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.07.022
DO - 10.1016/j.ijcard.2012.07.022
M3 - Article
C2 - 22959395
AN - SCOPUS:84883825104
VL - 167
SP - 2889
EP - 2894
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 6
ER -