The prevalence of coronary artery disease in the Romanian population evaluated by coronary CT angiography.

摘要

Objective: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide. Coronary CT angiography(CCTA) represents a non-invasive investigation with high sensibility in evaluating coronary artery stenosis and plaque features. The aimof our study is to assess the prevalence and characteristics of CAD evaluated using CCTA in the Romanian population. Material and Method:We retrospectively reviewed 1027 patients who performed a CCTA examination between January 2014 and February 2019. The indicationsfor CCTA were: atypical angina, typical angina with an inconclusive stress test, patients with intermediate/high-risk for major cardiac events.We excluded from this study the patients with significant arrhythmias which made impossible an optimal evaluation of all coronary segments.Results: Our study population included 552 females and 475 males, with a mean age of 58.3 ± 13.8 years. We analyzed 4108 coronary segmentsand 2566 coronary plaques were depicted. Obstructive CAD was diagnosed in 23.9% patients (552), while 39.8 % of the subjects had completeabsence of coronary stenosis. The majority of significant stenoses (20.9%) involved the proximal segment of the left descending artery, thisbeing also the location of the majority of calcified plaques (18.2%).42.3% patients had 0 coronary artery calcium score (CACS), while CACS 400 was found in 16.7% individuals. There was a significant difference among genders and the degree of coronary stenosis, with males havingmore than 3 times higher odds of developing significant luminal narrowing in all the coronary arteries (p0.001), except from left mainartery (LM) (p=0.05). Plaque analysis also showed a significantly higher proportion of overall affected segments and a higher proportion ofnon-calcified plaques in males (p 0.0001, p=0.002). CACS scores were significantly higher among older patients and among males (p0.001,p0.001). Moreover, there was a significant difference regarding the age and the degree of coronary stenosis, older subjects being more likelyto be diagnosed with obstructive CAD (coronary stenosis ≥ 50%). We diagnosed 12.1% (122) patients with coronary artery anomalies, including11 hemodynamically significant anomalies. Conclusion: To the best of our knowledge, this is the first study performed in Romania regardingthe burden of cardio-vascular disease studied by CCTA. This brings priceless information regarding the paradigm of CAD in our country.