EVALUATION OF SUSPECTED AND KNOWN CORONARY ARTERY DISEASE BY 128-SLICE MULTI-DETECTOR COMPUTED TOMOGRAPHY: A CROSS-SECTIONAL STUDY CONDUCTED AT THE ISLAMABAD DIAGNOSTIC CENTRE, PESHAWAR

Abstract

Background: Coronary artery disease (CAD) is a leading cause of cardiovascular morbidity and mortality worldwide, with a rising burden in Pakistan. While invasive coronary angiography remains the gold standard for coronary assessment, 128-slice multi-detector computed tomography (MDCT) has emerged as a reliable non-invasive alternative. This study evaluated the diagnostic utility of 128-slice MDCT coronary angiography in patients with suspected or known CAD. Methods: This cross-sectional study was conducted at Islamabad Diagnostic Centre, Peshawar, from January to June 2025. A total of 384 patients were enrolled and selected according to predefined inclusion and exclusion criteria. Demographic, clinical, and imaging data were collected using a structured questionnaire. All participants underwent 128-slice MDCT coronary angiography, and findings were analyzed for stenosis severity, vessel involvement, and plaque morphology using SPSS version 23. Results: Significant coronary artery stenosis was identified in 70% (n=269) of patients. The left anterior descending (LAD) artery was the most frequently involved vessel (45%), followed by the right coronary artery (24%), left circumflex artery (18%), left main coronary artery (6%), and multi-vessel disease (7%). Plaque analysis revealed calcified plaques in 38%, non-calcified plaques in 33%, and mixed plaques in 29% of affected patients. Hypertension (58%) and diabetes mellitus (42%) were the most common cardiovascular risk factors. Conclusion: 128-slice MDCT coronary angiography is an effective and reliable non-invasive modality for evaluating patients with suspected or known CAD. Its ability to accurately detect significant coronary stenosis, particularly in the LAD artery, supports its role as a valuable first-line imaging tool in clinical practice.

Keywords: Coronary artery disease; 128-slice multi-detector computed tomography; coronary CT angiography; coronary stenosis; plaque morphology.