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Coronary computed tomographic angiography found to detect disease when other imaging fails.

Coronary computed tomographic angiography (CCTA) was superior to single photon emission computed tomography ( SPECT ) at detecting coronary artery disease among patients with type 2 diabetes mellitus, according to a study in the Oct. 1 issue of the American Journal of Cardiology.

Eue-Keun Choi, M.D., of the Seoul National University College of Medicine in South Korea, and colleagues performed SPECT and CCTA on 116 diabetic patients ages 45 to 85 years with two or more coronary artery disease risk factors but no chest pains, or prior evidence of coronary artery disease or peripheral artery disease.

The researchers found that 88 subjects (76 percent) had normal SPECT images, while perfusion defects were found in 28 subjects (24 percent). With CCTA imaging, 92 subjects (79 percent) had evidence of atherosclerotic plaques and 20 (17 percent) had evidence of significant stenosis. The authors further note that patients with normal SPECT images had coronary artery disease prevalence on CCTA similar to that of those with abnormal SPECT images.

"In conclusion, a significant percentage of patients with diabetes mellitus and normal electrocardiographic findings, no peripheral arterial disease, and normal findings on SPECT have evidence of occult coronary artery disease on CCTA. Furthermore, a small percentage had had a cardiac event by mid-term follow-up. SPECT showed limited capability to differentiate the coronary risks between patients with diabetes mellitus and no coronary plaque from those with a certain degree of disease; two circumstances that represent different coronary risks," Choi and colleagues conclude.

Source: ModernMedicine

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