Tehran University Medical Journal

Background: Multislice computed tomography (MSCT) is a noninvasive method of detecting coronary artery disease (CAD). The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64-MSCT) in daily practice, without patient selection.

Methods: Sixty-four consecutive suspected CAD patients underwent both 64-MSCT and quantitative coronary angiography (QCA). The CT system The mean time span between MSCT and QCA was 7.2±3.9 days. For the 64-MSCT, detection or exclusion of CAD, defined as one or more areas of >50% stenosis within major epicardial coronary arteries, the sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV), and negative predictive value (NPV) were evaluated both per patient and per segment.

Results: Sixty-one of the 64 coronary CT angiograms (95%) were of diagnostic image quality. QCA showed significant CAD in 64% (39/61) of the patients, with the other 36% (22/61) showing nonsignificant disease or no disease. Sensitivity, specificity, accuracy, PPV, and NPV of 64-MSCT per patient were 92%, 86%, 90%, 92% and 96%, respectively. By the per-segment analysis, 695 of 791 coronary artery segments were assessable (88%). Of these, 64-MSCT showed a sensitivity of 80%, specificity of 92%, accuracy of 90%, PPV of 65%, and NPV of 96%, respectively, in detecting CAD.

Conclusions: Both per patient and per segment analyses for coronary 64-MSCT showed a higher diagnostic accuracy than QCA. This suggests 64-MSCT should primarily be used for risk stratification on a per patient basis as a noninvasive gate-keeper diagnostic method.

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Coronary Artery Disease (CAD) is a major cause of death worldwide including Iran.  The risk of developing disease in patients without symptoms is assessed in part by factors that are associated with disease. Among these factors family history points to the significance of genetic component in the risk of CAD. The identification of the genetic variants that confer risk for CAD is essential for detecting high-risk individuals, so preventative life style and therapeutic action can be taken before overt disease develops. So far more than 100 genes have been reported with possible role in developing risk for CAD. Matrix- Gla Protein (MGP) is one of these genes that association of its single nucleotide polymorphism (SNP) with CAD has been reported.  Among the polymorphisms, there are two promoter SNPs at position -7 & -138 that their association with CAD has been reported before. Here we investigated the association of these SNPs with CAD in Iranian population.
Methods: 150 cases and 150 controls were selected on the basis of their clinical assessments and angiographic reports. DNA was extracted from blood samples. The genotypes for both SNPs were determined using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method with size fractionation on Polyacrylamide gel.
Results: The comparison of allele & genotype frequencies between patients and controls showed that there is an excess of A allele at position -7 and T allele at position -138 among patients, although these differences were not significant (p<0.2, and p<0.5 respectively).
Conclusions: This study suggests no association of these SNPs with CAD in Iranian population. Confirmation of this finding needs independent repeat of similar studies.
Keywords: Coronary Artery Disease (CAD), Matrix Gla Protein (MGP), Single Nucleotide Polymorphism (SNP).

Background: It has been shown that coronary artery calcium scoring (CACS) can be used as a diagnostic method in coronary artery disease (CAD). The relationship between CACS and calcium metabolism in the body has been shown. The arterial calcification is an organized process similar to bone formation which is controled by parathormone (PTH). The relationship between PTH as an osteoregulatory factor and CACS has been also indicated. In this study, we tried to assess the value of serum PTH and CACS in patients planned to undergo coronary angiography (CAG) in order to find a simple, cost -benefit, noninvasive way, for ruling in/out obstructive CAD.
Methods: In a cross sectional study in Imam Khomeini hospital in 1390, CACS by using non-enhanced multi detector computed tomography (MDCT) and measurement of serum level of PTH, Calcium and Phosphate were done in 178 patients suspected to CAD which were scheduled to undergo coronary angiography serum PTH was measured by immuno-radiometric assay (IRMA) and serum Ca and Phosphate were measured by spectrophotometry methods.
Results: Of 178 Patients, 50 patients were females and 126 patients were male. Mean age of them was 56.2±11.6. The correlation coefficient between CACS and Gensini score (0.507, P<0.001), PTH (0.037, P=0.693), Ca (0.062, P=0.499) and Phosphate (0.061, P=0.506) were obtained. The level of serum PTH in the patients with and without coronary artery disease were 21.8±11.6 pg/dl, 23.2±11.5 pg/dl (P=0.427) respectively.
Conclusion: Our study showed association between CACS and CAD that was statistically significant while no relationship was found between PTH, CACS and CAD.