Abstract
The purpose of this study was to describe the application of coronary computed tomography angiography (CCTA) in evaluation of patients with history of intravenous drug use (IDU). An IRB approved retrospective review was performed of all patients who had a prior history of IDU and presenting with endocarditis who had undergone CCTA. Demographic characteristics and cardiovascular risk factors were collected. In addition, we reviewed CCTA reports for dosimetric parameters, calcium score, and atherosclerotic burden. There were 32 patients (25 males) included in this study with a mean age of 38 ± 10.8 years. The average BMI for the study group was 26.5 ± 4.9. 44 % of patients had evidence of atherosclerotic disease on coronary CTA. Mean calcium score was 175 ± 487. Median total exam effective dose was 4.8 mSv (range: 3.3–7.3 mSv). In spite of their relatively young age and BMI at the upper limits of normal, patients with history of IDU have atherosclerosis and coronary CTA can be utilized to screen these patients and may be helpful for risk stratification prior to noncoronary surgical procedures. Given the recent rise in IDU, this may become a growing indication for CCTA.
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CDC (2007) Drug-associated HIV transmission continues in the United States. Accessed Nov 2011: http://www.cdc.gov/hiv/resources/factsheets/idu.htm. Accessed April 20, 2015
Lansky A, Finlayson T, Johnson C, Holtzman D, Wejnert C, Mitsch A et al (2014) Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PLoS One 9(5):e97596
Jones CM, Logan J, Gladden M, Bohm MK (2015) Vital signs: demographic and substance use trends among heroin users—United States, 2002–2013. CDC Morb Mortal Wkly Rep 64(26):719–725
Lange RA, Hillis LD (2001) Cardiovascular complications of cocaine use. NEJM 345:351–358
Darke S, Kaye S, Duflou J (2006) Systemic disease among cases of fatal opioid toxicity. Addiction 101:1299–1305
Entrikin DW, Gupta P, Kon ND, Carr JJ (2012) Imaging of infective endocarditis with cardiac CT angiography. JCCT 6(6):399–405
Chen JJ, Manning MA, Frazier AA, Jeudy J, White CS (2009) CT angiography of the cardiac valves: normal, diseased, and postoperative appearances 1. Radiographics 29(5):1393–1412
Messika-Zeitoun D, Serfaty JM, Laissy JP, Berhili M, Brochet E, Iung B, Vahanian A (2006) Assessment of the mitral valve area in patients with mitral stenosis by multislice computed tomography. J Am Coll Cardiol 48(2):411–413
Alkadhi H, Wildermuth S, Plass A, Bettex D, Baumert B, Leschka S, Boehm T (2006) Aortic stenosis: comparative evaluation of 16-detector row CT and echocardiography 1. Radiology 240(1):47–55
Feuchtner GM, Dichtl W, Schachner T, Müller S, Mallouhi A, Friedrich GJ, Nedden DZ (2006) Diagnostic performance of MDCT for detecting aortic valve regurgitation. Am J Roentgenol 186(6):1676–1681
Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I et al (2009) Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the task force on the prevention, diagnosis, and treatment of infective endocarditis of the European Society of Cardiology (ESC). Eur Heart J 30:2369–2413
Vahanian A, Baumgartner H, Bax J et al (2007) Guidelines on the management of valvular heart disease: the task force on the management of valvular heart disease of the european society of cardiology. Eur Heart J 28:230–268
Kung V, Jarral OA, Shipolini AR, McCormack DJ (2011) Is it safe to perform coronary angiography during acute endocarditis? Interact CardioVasc Thorac Surg 13(2):158–167
Hekimian G, Kim M, Passefort S, Duval X, Wolff M, Leport C, Messika-Zeitoun D (2010) Preoperative use and safety of coronary angiography for acute aortic valve infective endocarditis. Heart 96(9):696–700
Ricci MA, Trevisani GT, Pilcher DB (1994) Vascular complications of cardiac catheterization. Am J Surg 167(4):375–378
Asano T, Sato K, Onodera, JI (2001) United Nations Scientific Committee on the effects of atomic radiation 2000 report
Feuchtner GM, Stolzmann P, Dichtl W, Schertler T, Bonatti J, Scheffel H, Alkadhi H (2009) Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol 53(5):436–444
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Prabhakar, A.M., Staziaki, P.V., Takx, R.A.P. et al. Preoperative evaluation for coronary atherosclerosis with computed tomography angiography in intravenous drug users: an emerging indication in the face of a growing threat. Int J Cardiovasc Imaging 32, 131–135 (2016). https://doi.org/10.1007/s10554-015-0719-6
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DOI: https://doi.org/10.1007/s10554-015-0719-6