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2000, Número 6

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Arch Cardiol Mex 2000; 70 (6)


Tomografía helicoidal computarizada de arterias coronarias vs angiografía coronaria

Sierra-Galán LM, Hernández-López JE, Portos-Silva JM

Idioma: Español
Referencias bibliográficas: 63
Paginas: 569-579
Archivo PDF: 249.91 Kb.


RESUMEN

Introducción: El índice de calcificación (IC) de las arterias coronarias (AC) por tomografía computada (TAC) es un procedimiento útil para el diagnóstico de enfermedad obstructiva coronaria (EOC), con sensibilidad del 82 ± 6%, especificidad del 88 ± 2%, valor predictivo positivo (VPP) del 57 ± 7% y valor predictivo negativo (VPN) del 96 ± 2%. Objetivos: Evaluación del método para la cuantificación del grado de calcificación en las AC por TAC en unidades Hounsfield con el método tradicional y definición de la sensibilidad, especificidad, VPP y VPN en comparación a la angiografía coronaria. Método: De junio de 1998 a marzo de 1999 se estudiaron 163 pacientes con TAC, 41 fueron sometidos a coronariografía. Las TACs se realizaron con un equipo ELSCINT CTTwin y un software para la cuantificación de la calcificación en las AC en unidades Hounsfield. Se consideró lesión significativa a la obstrucción ≥ 50% en el tronco de la coronaria izquierda y ≥ 70% en al menos una de las arterias principales o ≥ 50% si existían dos o más arterias involucradas. Aquellos con coronariografía se dividieron en dos grupos: A con índice de calcificación ≤ 150 y B ≥ 151. Resultados: En el grupo A el 45% tuvo lesiones significativas vs 95% en el grupo B, p = 0.001: Sensibilidad del 65%, especificidad del 95%, VPP y VPN del 64% y 92%, respectivamente. Riesgo relativo de 2.08 (IC 95% 1.38-3.54) y razón de momios 21.6 (IC 95% 2.43-191.37). Conclusiones: Aún con una muestra reducida de pacientes, la tomografía resulta ser un procedimiento útil para el diagnóstico de EOC significativa.


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