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Due to technical advances, multidetector computed tomography (MDCT) allows evaluation of the coronary arteries and could in specific clinical indications provide a minimally invasive alternative to coronary angiography (CA). Recent technical advances combined with the availability of 64 row MDCT have significantly improved the evaluation of the native coronary arteries. However limitations remain for the evaluation of bypass grafts and stents. In this paper, we present a review the current literature on the diagnostic accuracy of 64 row MDCT in the assessment of coronary artery disease, and discuss the clinical implications and proposed indications of coronary CTA.

The anomalous lipemic values are considered as a risk factor in coronarial pathology. We are separately studying different lipemic factors, Lp(a) in the present paper. May be our 38 clinical cases are still a too small number to demonstrate any correlation between Lp(a) haematic content and arterial pathology, and we will continue this study in the evolution of the pathology, eventually until the infarctus. For the moment, we established the significance of correlation between two methods in two laboratories of ours (in Pavia, Italy, and in Lisboa, Portugal). Correlation is more than 0.9. Assays were done on the same air mailed samples.

The association in many populations of the fat content of the diet and frequency of ischemic heart disease is mentioned. The author gives a summary of papers showing on one hand, a high correlation between the content of the diet in saturated fatty acids and ischemic heart disease morbidity and mortality rates, and, on the other hand, the protective effect of a change towards more polyunsaturated fatty acids in the diet. Several teams of Belgian researchers have recently published new facts on this matter. In the Northern Flemish speaking part of the country, saturated fatty acids have been partially replaced by polyunsaturated fatty acids from vegetable sources. This change has been followed by a general decrease of ischemic heart disease incidence, prevalence and mortality rates. In the Southern French speaking part of the country, the alimentary changes have not occurred so far; the ischemic heart disease morbidity and mortality rates stand higher.