Hatzidakis Adam, Savva Eirini, Perisinakis Konstantinos, Akoumianakis Evangelos, Kosidekakis Nikolaos, Papadakis Antonios, Hamilos Michail, Kochiadakis Georgios
Department of Radiology, AHEPA University Hospital, Aristotle University, Medical School of Thessaloniki, Greece.
Department of Internal Medicine, University Hospital of Heraklion, Greece.
Hellenic J Cardiol. 2021 Mar-Apr;62(2):129-134. doi: 10.1016/j.hjc.2020.04.004. Epub 2020 Apr 15.
To study the necessity of coronary artery screening with computerized tomography coronary angiography (CTCA) in asymptomatic male patients.
A total of 226 asymptomatic male patients aged over 50 years were included in this prospective study, according to a clinical protocol approved by the Heraklion University Hospital's Ethics Committee. All participants had at least 3 or more known atherosclerosis risk factors. All patients had none or normal noninvasive cardiological tests in the past and had no contraindications for CTCA. All patients gave their informed consent after being notified regarding contrast medium and radiation dose risks.
Significant stenoses were found in 52 asymptomatic males (23%). Out of them, 38 male patients underwent invasive coronography and 14 patients were lost in follow-up. In 18 patients, no lesions were found (47.4%). In the other 20 (52.6%) patients, 28 lesions were found. Stent placement was performed in 11 patients, bypass surgery was proposed in 3 patients, and in another 6 patients conservative treatment was suggested. Patients with findings in CTCA were more likely to have a family history of coronary artery disease, compared to patients with normal CTCA (P < 0.05 by using Fischer's Exact Test). Sensitivity of CTCA for significant stenosis was 74.3% with a specificity of 62%.
CTCA may be used to screen for clinically significant coronary artery disease (CAD) in asymptomatic male patients, particularly those with positive family history or potentially high-risk patients with >3 risk factors for CAD.
研究计算机断层扫描冠状动脉造影（CTCA）对无症状男性患者进行冠状动脉筛查的必要性。
根据伊拉克利翁大学医院伦理委员会批准的临床方案，本前瞻性研究纳入了226例年龄超过50岁的无症状男性患者。所有参与者至少有3种或更多已知的动脉粥样硬化危险因素。所有患者过去均无或无创心脏检查正常，且无CTCA的禁忌证。所有患者在被告知造影剂和辐射剂量风险后均给予了知情同意。
52例无症状男性（23%）发现有明显狭窄。其中，38例男性患者接受了有创冠状动脉造影，14例患者失访。18例患者未发现病变（47.4%）。在其他20例（52.6%）患者中，发现了28处病变。11例患者进行了支架置入，3例患者建议进行搭桥手术，另外6例患者建议进行保守治疗。与CTCA正常的患者相比，CTCA有异常发现的患者更可能有冠状动脉疾病家族史（使用Fisher精确检验，P<0.05）。CTCA对明显狭窄的敏感性为74.3%，特异性为62%。
CTCA可用于无症状男性患者临床显著冠状动脉疾病（CAD）的筛查，特别是那些有家族史阳性或有>3种CAD危险因素的潜在高危患者。
