Publications by authors named "A Villanueva Jeremias"
Coronary artery disease (CAD) is the leading cause of mortality among patients with chronic kidney disease (CKD), presenting unique challenges in diagnosis and management. Advanced CKD patients often present with atypical symptoms, and conventional diagnostic and interventional approaches carry risks, including contrast-induced nephropathy and the potential need for renal replacement therapy. These risks have led to the phenomenon of "renalism," where necessary procedures may be deferred due to concerns over renal injury.
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- Calcified nodules (CNs) are high-risk lesions that can emerge from untreated calcified lesions, leading to serious health issues like cardiac death and myocardial infarction.
- A study with 372 patients tracked the development of new CNs over approximately 1.5 years, finding that 7% of lesions showed new CNs at follow-up.
- Factors like the presence of residual lipid, larger calcified volume, increased motion during heart cycles, and longer time since initial imaging were linked to the formation of new CNs and were associated with worse clinical outcomes.
Article Synopsis
- Photon-counting detector-computed tomography (PCD-CT) technology offers better spatial resolution and may improve diagnostic performance for obstructive coronary artery disease (CAD) compared to traditional energy-integrating detector computed tomography (EID-CT).
- A study of 7,833 patients showed that those who had PCD-CT were less likely to be referred for invasive coronary angiography (ICA) and had higher rates of revascularization when referred.
- PCD-CT demonstrated significantly better specificity, positive predictive value, and diagnostic accuracy at the vessel level compared to EID-CT, with similar sensitivity and negative predictive value results.