1111 poster, cat 11
ROLE OF CORONARY CT ANGIOGRAPHY IN STAGE 3 CHRONIC KIDNEY DISEASE – RETROSPECTIVE ANALYSIS
A.A. Mohammed1,2 , W. Ananthapanyasut1,2, A. Syed1,2, T. Harindhanavudhi1,2,
M. Hamarshi1,2, B. Alhariri1,2, T. Takale1,2, E. Lerma1,2 , T. Levin1,2
1University of Illinois, Chicago, IL, USA, 2Advocate Christ Medical Center, Oak Lawn, IL, USA
CKD is a known independent risk factor for CAD. Coronary CT angiography (CTA) is a non-invasive imaging modality that has been used to detect CAD. However, its use is limited due to risk of radiocontrast induced nephropathy and possible vascular calcification which often leads to indeterminate results. We retrospectively studied the role of CTA in stage 3 CKD patients. METHODS: We extracted data from Christ Medical Center - CTA database for 1 year. 186 patients underwent CTA using a Phillips 64 slice scanner. The most common indications were chest discomfort and equivocal stress test. All patients received a fixed bolus of 90 ml of iodinated contrast. Out of 186 patients, we identified 19 patients who were classified as having stage 3 CKD (MDRD calculated GFR of 30 to 59 ml/min/1.73m2). Using the AHA model, the degree of stenosis was estimated in 15 coronary artery segments. Stenosis > 50% per segment was considered significant. The results of CTA were compared to conventional coronary angiography.RESULTS: The feasibility was 94.3%. 13 out of 19 (68.4) patients were identified to have CAD and 8 had subsequent conventional coronary angiography. The sensitivity, specificity, and positive and negative predictive values of MDCT for the identification of >50% stenosis were 73%, 100%, 100% and 97% respectively. There was no significant change in GFR after CT angiography.CONCLUSION: CTA is useful, fairly accurate and potentially safe non-invasive imaging technique for use in stage 3 CKD patients and may represent a reasonable screening study for CAD in this population.