ISSN 2996-8215
International Journal of Cardiology | Vol. 1, No. 8, August 2010 | pp. 57–64
DOI: 10.46882/2010/IJC/000017
Original Research Article
Diagnostic Accuracy of 64-Slice Computed Tomography Coronary Angiography compared with Invasive Coronary Angiography
Ahmed Al-Hassan¹, Fatima Al-Sayed¹, Youssef Benamour²
¹Department of Cardiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
²Division of Cardiovascular Radiology, Ibn Rochd University Hospital, Casablanca, Morocco
Abstract:
Multislice computed tomography coronary angiography (CTCA) has advanced rapidly as a non-invasive imaging modality for evaluating coronary artery disease (CAD). We evaluated the diagnostic performance of 64-slice CTCA in detecting hemodynamically significant coronary stenosis, using conventional invasive coronary angiography (ICA) as the gold standard reference. A prospective study was conducted on 150 symptomatic patients suspected of having stable CAD who were scheduled for ICA. All patients underwent 64-slice CTCA within 2 weeks prior to ICA. Coronary segments were assessed for the presence of significant stenosis, defined as a luminal diameter reduction greater than or equal to 50%. On a patient-based analysis, CTCA successfully identified significant CAD in 88 out of 94 patients confirmed by ICA. The patient-based sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 64-slice CTCA were 93.6% (95% CI: 86.6%–97.6%), 85.7% (95% CI: 73.8%–93.6%), 91.7% (95% CI: 84.2%–96.3%), and 88.9% (95% CI: 77.4%–95.8%), respectively. On a segment-based analysis (1,985 segments evaluable), the overall sensitivity and specificity were 86.4% and 95.8%. Diagnostic accuracy was lower in segments with severe calcification (Agatston calcium score greater than 400). No major adverse events were reported during CTCA scanning. Sixty-four-slice computed tomography coronary angiography provides high diagnostic accuracy and an exceptional negative predictive value for ruling out significant coronary artery disease in symptomatic patients, making it a reliable clinical triage tool prior to invasive angiography.
Keywords: Computed tomography coronary angiography, Invasive coronary angiography, Coronary artery disease, Sensitivity, Specificity, Diagnostic accuracy
Received: May 02, 2010; Revised: June 15, 2010; Accepted: July 04, 2010; Published: August 20, 2010
Citation: International Journal of Cardiology, 2010, Vol. 1, No. 8, pp. 57–64, DOI: 10.46882/2010/IJC/000017
International Journal of Cardiology | Vol. 1, No. 9, September 2010 | pp. 65–72
DOI: 10.46882/2010/IJC/000018
Original Res