An exploratory study using left main and right coronary artery diameter and heart mass assessed on post-mortem computed tomography to identify ischaemic heart disease

Coronary artery calcification is used to identify ischaemic heart disease (IHD) on post-mortem computed tomography (PMCT), but with inherent limitations. Using an alternative approach, this study explored coronary artery diameters and estimated heart mass to identify IHD on PMCT. A 6-year retrospective study was performed comparing the sum of the left main coronary artery and right coronary artery diameters to the power of four/heart mass (CAA–HM ratio) between control (92 subjects) and IHD (63 subjects) using PMCT. In control, only age was associated/correlated with the CAA–HM ratio, whereas in the IHD, no factors were associated/correlated with the CAA–HM ratio. A subsequent case-control study selecting subjects aged 50–75 (control: 32 subjects, IHD: 34 subjects) showed the CAA–HM ratio was significantly higher in IHD (t-test, p < 0.05). The area under the curve in the plotted receiver operating characteristics was 0.847 (specificity: 0.719, sensitivity of 0.853), with the optimal cut-off ratio being 0.202 (10−3 mm4/g). This study showed that the CAA–HM ratio was higher and could differentiate IHD with reasonable accuracy from control aged 50–75 years. It may serve as an adjunct in identifying IHD on PMCT. Further validation and subsequent studies comparing and incorporating other PMCT parameters for IHD are recommended.