A propensity score-based comparison of flat panel digital detector fluoroscopy versus digital cinefluoroscopy for coronary artery calcium detection

Abstract

Introduction: Detection of coronary artery calcification (CAC) allows for a refined prediction of cardiovascular risk beyond global risk assessment algorithms. Newer-generation, high-resolution, flat-panel digital detector (FPDD) fluoroscopic systems may provide higher CAC detection rates compared with older fluoroscopic devices.

Methods: We compared the CAC detection rates of two fluoroscopic techniques in two different cohorts of asymptomatic individuals, analyzed within a two-decade time interval.

Results: FPDD detected CAC more frequently than the older fluoroscopy device, in the more recent and the older patient cohort of individuals, respectively. After propensity score matching to account for differences in age and risk factor prevalence, the adjusted rates of CAC detection remained higher in favor of FPDD (37.7% vs. 23.7%, p=0.026).

Conclusions: The ability of newer cine-fluoroscopic systems to identify CAC in a larger number of asymptomatic, intermediate-risk individuals may have implications for further risk stratification, management of risk factors and long-term prognosis.