Computed Tomography Coronary Angiography Is Feasible and Reliable for Proximal Coronary Segment Interpretation in Patients with Elevated Body Mass Index
2024

CT Coronary Angiography in Obese Patients

Sample size: 703 publication 10 minutes Evidence: moderate

Author Information

Author(s): Salib Anthony, Hay Michael, Muthalaly Rahul, Abrahams Timothy, Sultana Nushrat, Kanna Raj, Rao Ravi, Abe Akira, Bastwrous John, Aldous Emma, Tu Huong, Paleri Sarang, Vasanthakumar Sheran, Patel Alisha, Nandurkar Rhea, Brown Adam, Lin Andrew, Nerlekar Nitesh

Primary Institution: Monash University

Hypothesis

CTCA remains adequate for proximal segment stenosis interpretation in obese patients despite concerns about non-evaluable testing.

Conclusion

CTCA is a feasible investigation for assessing proximal coronary segments in most patients with elevated BMI, providing important prognostic information.

Supporting Evidence

  • 93.5% of the studies were fully evaluable.
  • 90% of proximal segments were evaluable in suboptimal studies.
  • Obesity was associated with a higher rate of suboptimal studies.
  • Noise artefacts were the main reason for suboptimal studies in patients with BMI ≥ 40.
  • CTCA provides important prognostic information even in suboptimal scans.

Takeaway

Doctors can use a special heart scan called CTCA to check the big blood vessels in overweight patients, and it usually works well even if the pictures aren't perfect.

Methodology

This retrospective cohort study analyzed CTCA results from patients grouped by BMI to assess image quality and evaluability of proximal coronary segments.

Potential Biases

Selection bias may occur as higher-risk patients might have been referred directly for invasive testing instead of undergoing CTCA.

Limitations

The study's retrospective nature may introduce bias, and it was conducted at a single clinical practice, which may not represent all patient populations.

Participant Demographics

Mean age was 59 years, 47% were men, and participants were grouped by BMI categories: 295 (18.5–24.9), 302 (25–39.9), and 106 (≥40).

Statistical Information

P-Value

p<0.01

Confidence Interval

[7.13, 11.91]

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.3390/jcdd11120400

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