Questionable necessity of nitroglycerin for diagnostic coronary artery examination using 320-row multi-detector computed tomography

Article type: Research Article

Authors: Lu, Nan-Han^{a; b; c} | Liu, Yi-Shan^{a; d} | Liu, Ko-In^{c; e; f} | Hsu, Shih-Yen^{c; e; f} | Huang, Yung-Hui^c | Sun, Cheuk-Kwan^{g; h} | Chen, Tai-Been^{c; *}

Affiliations: [a] Department of Pharmacy, Tajen University, Pingtung, Taiwan | [b] Department of Radiology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan | [c] Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan | [d] Department of Dermatology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan | [e] Department of Radiology, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan | [f] Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan | [g] Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan | [h] School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan

Correspondence: [*] Corresponding author: Tai-Been Chen, Ph.D., Department of Medical Imaging and Radiological Sciences, I-Shou University. No. 8 Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City 82445, Taiwan, R.O.C. Tel.: +886 7 6151100 ext 7814; Fax: +886 7 6155150; E-mail: ctb@isu.edu.tw.

Abstract: OBJECTIVE:This study aims to analyze and compare the diagnostic effectiveness of 320-row multi-detector computed tomography for coronary artery angiography (MDCTA) in subjects with and without sublingual vasodilator (nitroglycerin). MATERIALS AND METHODS:From September 2015 to September 2016, 70 individuals without history of major cardiovascular diseases who underwent MDCTA for health examination were retrospectively categorized into sublingual nitroglycerin (NTG) and non-NTG groups. Medical history, CT dose index (CTDI), and multi-slice CT images were compared between two groups. A diameter of coronary artery (DA, mm) was computed and analyzed. RESULTS:A total of 41 males and 29 females (mean age: 55.43±8.84 years, range: 34– 76) were reviewed. Normal and abnormal MDCTA findings were noted in 54 and 16 participants, respectively, with the detection rate of coronary artery disease being 23%. There was no significant difference in inter-observer variability of coronary CTA image quality and diagnosis between the NTG and non-NTG groups among three experienced radiologists. Although the percentage dilatation of left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX) following in the NTG group were 12.4%, 12.8% and 25.3%, respectively (p < 0.01), there was no significant difference in image quality and diagnosis between the two groups. CONCLUSIONS:Despite the recommendation of routine nitroglycerin use for subjects undergoing computed tomography for coronary artery angiography, our results showed no significant advantage of its use in improving image quality and rate of diagnosis accuracy.

Keywords: Multi-detector computed tomography for coronary artery angiography (MDCTA), coronary artery disease, nitroglycerin

DOI: 10.3233/XST-200652

Journal: Journal of X-Ray Science and Technology, vol. 28, no. 5, pp. 989-999, 2020