ROLE OF CTA AND CAC SCORING TECHNIQUES TO ENHANCE CAD DIAGNOSIS IN STABLE CHEST PAIN PATIENTS

Abstract

Introduction:

CAD can be fatal and occurs in the form of stable chest pain. The disease may not necessarily manifest symptoms that would confirm its presence in an individual. The detection of the disease at its onset is crucial since the symptoms may be inaccurate. One of the measures to detect the disease is the coronary artery calcium score, which calculates the amount of plaque in the coronary arteries and predicts the risk. Additionally, CT angiography produces clear images of the coronary arteries and plaques. The integration of the two measures improves the effectiveness of detecting CAD.

Aim of the Study: To determine how CTA and CAC scoring techniques enhance the diagnosis of CAD in stable chest pain patients referred for angiography.

Methodology: Cross sectional Analytical study was conducted at Farooq Hospital Lahore for four months, to determine how CTA and CAC scoring enhance the diagnosis of CAD. A total of 73 patients underwent scans using a computed tomography (128 slice Toshiba), with all observations recorded by radiologists. Data analysis was performed using SPSS 27.0 to determine distribution, frequency, percentage, and diagnostic accuracy.

Results:

There were 73 participants involved in the research, most of whom were males. Several participants exhibited stenosis symptoms. In addition, most of the clinical findings observed indicated either stenosis or absence of any abnormality. Most of the participants in this case had a zero CAC score but suffered from CAD. The statistical analysis conducted via Pearson Chi-Square indicated that there was a significant relationship between chest pain and CAC (p=0.021), indicating that there was a significant relationship between CAC and chest pain. However, there was no significant relationship between chest pain and CAD (p=0.493). In addition, there was a highly significant relationship between clinical findings and CAC (p=0.010), and CAC and CAD (p=0.020).

Conclusion: The usefulness of the coronary CTA and CAC scoring techniques can be demonstrated on those patients who have stable chest pain and undergo coronary angiography. As found in this study, coronary CTA and CAC score are efficient imaging techniques, which help significantly improve diagnosis of CAD. The presence of calcium correlates well with coronary atherosclerotic plaque, since, as shown in the study, an increase in the CAC score leads to a higher probability of the presence of CAD. With the aid of coronary CTA technique, the accuracy of the diagnosis improved further due to providing an accurate visualization of coronary anatomy and detection of stenosis, which would remain invisible during clinical examination. Although CTA was more helpful for anatomical analysis of the coronary arteries, the CAC score could serve as a risk stratification tool prior to CTA