The importance of Coronary Computed Tomography Angiography and Coronarography in evaluation of coronary artery stenosis

Skaistė Dalia Baltrušaitytė1, Gintarė Vaičaitytė1, Gediminas Jaruševičius2,3

1 LSMU MA Medicinos fakultetas,

2 LSMUL KK Kardiologijos klinika,

3LSMU Kardiologijos institutas


The aim: the aim is to compare Coronary Angiography (CA) and Coronary Computed Tomography Angiography (CCTA) possibilities in determining the degree of coronary artery damage.

Methods: the data from the hospital of Lithuanian University of Health Sciences (LUHS) Kaunas Clinics Cardiology and Radiology departments were used. In this research we included 172 patients to whom both – CCTA and CA, tests for the same patient were done in one year, the data was taken from 2014 – 2016. Data analysis were performed with „IBM SPSS 22.0“ and „MS Office Excel 2010“ programs. Statistical significance level p<0,05.

Results: between 2014 – 2016 in the hospital of LUHS Kaunas Clinics Cardiology and Radiology departments coronary CCTA and CA were performed for 172 patients (mean age 66,4±9,6 y.), of whom 49,4% men (mean age – 62,4±9,5 y.) and 50,6% women (mean age – 70,3±8,0 y.). The grade of coronary artery stenosis detected by CCTA and CA matched in average 9,2±2,5 segments, statistically significant more segments in women than in men (9,6±2,5 and 8,7±2,5 respectively). Negative correlation between patient ‘s age and the number of matched segments detected by CCTA and CA were found (r=-0,19, p=0,012). Statistically significant difference was observed between these two diagnostic procedures in evaluation of 1, 4, 6, 8, 9, 11, 12, 14 segments, while evaluation of 2, 3, 5, 7, 10, 13, 15 segments were not statistically significant. Inter-rater agreement (kappa) was evaluated (stenosis were differentiated by calcification and significance) – moderate agreement between CCTA and CA was observed in total and by segments (total weighted kappa – 0,48±0,07, p<0,05).

Conclusions: no good agreement between CCTA and CA evaluation of damaged segments was observed. Considering significant (>50%) and non-significant stenosis of coronary artery, moderate agreement is in evaluating 1, 2, 7 segments, while poor agreement is in evaluating 8, 12. Considering calcified and non – calcified stenosis of coronary artery, moderate agreement is in evaluating 1,2,11 segments. The evaluation of stenosis in 7 segment doesn’t change according to calcification. The number of matched segments between these test ‘s results are higher in women ‘s group than in men ‘s.

Key words: coronary artery disease, coronary angiography, coronary CT angiography (CCTA).