Jin Gong Yong
Taehan Yongsang Uihakhoe Chi. 2022 Jan;83(1):54-69. doi: 10.3348/jksr.2021.0161. Epub 2022 Jan 21.
Early detection of potential asymptomatic coronary artery disease is very important, as patients with sudden cardiac death often do not show symptoms such as chest pain or motor dyspnea. Coronary CT angiography (CCTA) has long been unjustified as a screening tool for asymptomatic patients because of the risks posed by radiation exposure. However, there are still various opinions regarding the usefulness of CCTA for screening for coronary artery disease (CAD) in asymptomatic healthy individuals or patients. This review investigated the usefulness of coronary artery calcium score and CCTA as screening tests for CAD in asymptomatic healthy individuals or patients through various literature reviews. With the development of CT technology, recent studies have been conducted in asymptomatic CAD patients with a reduced radiation dose of less than 1 mSv. A total of 2.6% of asymptomatic subjects on CCTA found significant CAD over 70%, and it was concluded that screening CCTA for CAD showed prognostic power in predicting the future occurrence of CAD in asymptomatic people. However, after the completion of the current NIH SCOT-HEART 2 study, it may be possible to determine whether CCTA is appropriate as a screening tool for CAD in asymptomatic healthy individuals.
早期发现潜在的无症状冠状动脉疾病非常重要，因为心源性猝死患者通常不会表现出胸痛或运动性呼吸困难等症状。长期以来，冠状动脉CT血管造影（CCTA）作为无症状患者的筛查工具一直未被认可，因为存在辐射暴露风险。然而，对于CCTA在无症状健康个体或患者中筛查冠状动脉疾病（CAD）的实用性仍存在各种观点。本综述通过各种文献回顾，研究了冠状动脉钙化积分和CCTA作为无症状健康个体或患者CAD筛查试验的实用性。随着CT技术的发展，最近对无症状CAD患者进行了辐射剂量低于1 mSv的研究。在CCTA检查中，共有2.6%的无症状受试者被发现患有严重CAD（超过70%），得出的结论是，对CAD进行CCTA筛查在预测无症状人群未来CAD发生方面具有预后价值。然而，在当前的美国国立卫生研究院（NIH）SCOT-HEART 2研究完成后，或许可以确定CCTA是否适合作为无症状健康个体CAD的筛查工具。
