Coronary CTA Would Facilitate Invasive Angiography in Patients With Acute Coronary Syndrome and Coronary Bypass Grafting History

Abstract

BackgroundThe uncertainties of grafts’ ostium and patency would cause prolonged procedure/fluoroscopy time and extra contrast agent consumption of the invasive coronary angiography (ICA) in patients with coronary artery bypass grafting (CABG) history. This study was conducted to evaluate whether the identification of grafts’ ostium and patency by coronary computed tomographic angiography (CTA) could facilitate ICA procedure.MethodsPatients with acute coronary syndrome (ACS) and CABG history who underwent ICA during hospitalization were enrolled. The patients were divided into the CTA–ICA group and the direct ICA group according to whether a coronary CTA was performed before ICA. The complete direct ICA was defined by successful selective angiography of all recorded grafts. The procedure/fluoroscopy time and contrast agent consumption of ICA were compared.ResultsThere were 14 patients in the CTA–ICA group and 24 patients in the direct ICA group. In the direct ICA group, twelve cases were conducted complete ICA. The CTA–ICA group had reduced procedure time (17.8 ± 7.1 vs. 25.9 ± 15.4 min, p = 0.03) and fluoroscopy time (fluor-time; 4.6 ± 2.3 vs. 9.8 ± 5.3 min, p < 0.01), and less contrast agent consumption (30.4 ± 5.6 vs. 49.8 ± 20.9 ml, p < 0.01) than the direct ICA group. In a subgroup analysis, the incomplete direct ICA had the longest procedure time (32.8 ± 16.5 min) or fluor-time (12.0 ± 5.5 min) and the most contrast agent consumption (58.3 ± 25.8 ml), whereas the difference between CTA–ICA and complete direct ICA groups was non-significant.ConclusionThe CTA would facilitate invasive angiography in patients with CABG by reducing procedure/fluoroscopy time and contrast agent consumption.