ISSN 2996-8215
International Journal of Cardiology | Vol. 13, No. 7, July 2022 | pp. 49–56
DOI: 10.46882/2022/IJC/000160
Original Research Article
Diagnostic Accuracy of High-Resolution 64-Slice CTCA for Coronary Stenosis Detection in Asymptomatic Hypertensive Cohorts
Chidi O. Okafor¹, Babajide A. Adebayo¹, Funmilayo K. Balogun²
¹Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
²Division of Cardiology, University College Hospital, Ibadan, Nigeria
Abstract:
Hypertension drastically accelerates coronary macrovascular atherosclerosis, but identifying significant structural disease before ischemic symptom onset remains clinically challenging. Computed tomography coronary angiography (CTCA) offers a non-invasive tracking alternative, but its precise accuracy within native West African hypertensive populations requires validation against gold-standard invasive coronary angiography (ICA). This prospective study evaluated the diagnostic performance of high-resolution 64-slice CTCA for detecting hemodynamically significant coronary stenoses. We evaluated 150 asymptomatic hypertensive individuals presenting with at least one additional cardiovascular risk factor who were scheduled for elective ICA. Significant obstructive CAD was defined as a luminal diameter reduction greater than or equal to 50%. On a patient-based analysis, CTCA successfully identified obstructive disease in 86 out of 92 patients confirmed via ICA. The patient-based diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 64-slice CTCA were 93.5% (95% CI: 86.3%–97.6%), 86.2% (95% CI: 74.3%–93.2%), 91.5% (95% CI: 84.0%–96.0%), and 89.3% (95% CI: 77.4%–95.6%), respectively. Segment-based specificity remained high at 95.8%. High-resolution 64-slice computed tomography coronary angiography achieves excellent diagnostic performance and an exceptional negative predictive value for ruling out significant obstructive coronary artery disease in asymptomatic hypertensive patients, serving as a reliable non-invasive triage tool.
Keywords: Computed tomography coronary angiography, Invasive coronary angiography, Hypertension, Obstructive coronary disease, Diagnostic accuracy, Negative predictive value
Received: April 05, 2022; Revised: May 18, 2022; Accepted: June 10, 2022; Published: July 24, 2022