Digital fluoroscopy and intravenous cardiac angiography for the detection of coronary artery disease in selected subjects

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Thirty-seven thin patients (height/weight ratio >2.2 cm/kg) without prior myocardial infarction underwent digital subtraction fluoroscopy and intravenous digital subtraction cardiac angiography one day before they were scheduled to undergo coronary angiography. Eighteen (49%) had at least a 50% obstruction of a major coronary artery as shown on selective coronary cineangiograms; eight of these (44%) had three calcified coronary arteries as visualized by digital fluoroscopy, five (28%) had diagnostic wall-motion abnormality by digital ventriculography, and 15 (83%) had intravenous angiographic evidence of at least one severe (>50%) coronary obstruction. Seventeen (94%) of the 18 with severe selective angiographic obstructions had at least one calcified artery detected by the digital study. Seventeen (89%) of the 19 without angiographic evidence of severe disease had none of these three abnormalities visualized on their digital intravenous images. Intravenous cardiac angiography was more accurate for predicting proximal coronary, right coronary, and left anterior descending branch obstructions, than for distal coronary and left circumflex artery obstructions.



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