Kohki Nakamura MD, Presenter: Nothing to Disclose

Nobusada Funabashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Masae Uehara MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Takaoka MD, Abstract Co-Author: Nothing to Disclose

Fumiaki Maeda, Abstract Co-Author: Nothing to Disclose

Issei Komuro MD, Abstract Co-Author: Nothing to Disclose

Kazushi Suzuki, Abstract Co-Author: Nothing to Disclose

Makoto Terao, Abstract Co-Author: Nothing to Disclose

Yoko Mikami MD, Abstract Co-Author: Nothing to Disclose

Yumi Shiina MD, Abstract Co-Author: Nothing to Disclose

To evaluate, using logistic regression models, the influence of body mass index (BMI) and stent size on the agreement between findings of 64-slice MSCT and conventional coronary angiography (CAG) for evaluating the patency of drug-eluting stents (DES) and bare metal stents (BMS) in coronary arteries.

49 subjects with 75 stents (16DES, 59BMS; 31LAD, 13LCx, 31RCA) underwent MSCT (Light Speed VCT) and CAG. BMI (kg/m2) was classified as: 30. Logistic models were made to predict the agreement between findings of CT and CAG for evaluating patency of stents considering age, sex, heart rate, BMI, diabetes mellitus, hypertension, stent size (diameter: 4, 3.5, 3, 2.75 or 2.5 mm) and stent type (DES or BMS).

By CAG, patency was confirmed in 94% of DES and 92% of BMS. Significant stenosis (>50%) was observed in 6% of DES and 7% of BMS, and total occlusion was observed in 2% of BMS. By CT, patency was confirmed in 69% of DES (83, 75 and 50% of 3.5, 3, and 2.5 mm stents, respectively), and in 78% of BMS (80, 78, 81, 100 and 57% of 4, 3.5, 3, 2.75 and 2.5 mm stents, respectively). 8% of BMS revealed a low CT area inside the stent (1 with 4, 1 with 3.5, 3 with 3 mm stents) with significant stenosis. 2% of BMS revealed total occlusion (1 with 3.5 mm, 1 with 2.5 mm stents). Patency of 31% of DES and 22% of BMS was unconfirmed. Complete agreement between CT and CAG findings was observed in 69% of DES and 80% of BMS.

The percentage of complete agreement between CT and CAG findings in each BMI category was 100, 74, 78 and 43, respectively. In logistic models, BMI was a significant negative predictor of agreement (relative risk, 0.77; 95% confidence intervals, 0.62–0.97). Comparing CT findings with CAG findings, the specificities and negative predictive values in each BMI category were 100, 72, 86, and 60%, and 100, 100, 95, and 100%, respectively. Type and size of stent were not significant predictors in any category.

64-Slice MSCT has a potential for evaluating patency of DES with a low incidence of restenosis. However, when BMI is high, especially >30 kg/m2, it is difficult to accurately evaluate stent patency irrespective of the type of stent.

Nakamura, K, Funabashi, N, Uehara, M, Takaoka, H, Maeda, F, Komuro, I, Suzuki, K, Terao, M, Mikami, Y, Shiina, Y, Influence of Body Mass Index on the Agreement between Findings of 64-slice CT and Findings of Conventional Coronary Angiography for Evaluation of Patency of Drug Eluting Stents and Bare Metal Stents in Coronary Arteries.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011892.html