Diagnostic Accuracy of 64-slice Computed Tomography Coronary Angiography in a Large Population of Patients Without Revascularisation: Registry Data on the Impact of Calcium Score

Overview

Journal Radiol Med

Specialty Radiology

Date 2011 Mar 25

PMID 21431299

Citations 4

Authors

E Maffei

C Martini

C Tedeschi

P Spagnolo

A Zuccarelli

T Arcadi

A Guaricci

S Seitun

A Weustink

N Mollet

F Cademartiri

Affiliations

Soon will be listed here.

Abstract

Purpose: This study evaluated the diagnostic accuracy of computed tomography coronary angiography (CTCA) for detecting significant coronary artery stenosis (≥50% lumen reduction) at different coronary calcium score (CACS) values with conventional coronary angiography (CAG) as the reference standard.

Material And Methods: A total of 1,500 patients (928 men, mean age 58.2±12.5 years) in sinus rhythm who underwent CTCA (64-slice technology) and CAG were enrolled. Diagnostic accuracy and likelihood ratios (LR) of CTCA were evaluated against CAG for the total population and in different CACS classes (0; 1-10; 11-100; 101-400; 401-1,000; >1,000).

Results: The prevalence of obstructive disease was 51% (23.5% single vessel; 27.5% multivessel; progressive increase from 17.9% to 94% through the CACS classes). In the per-patient analysis, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CTCA were 99%, 92%, 94% and 99%, respectively. Per-patient analysis showed a worse PPV of CTCA (76-77%) in classes with low CACS (1-10/11-100). Per-patient LR were higher in classes with extreme CACS values (0 = LR+ 18.3 and LR- = 0.0; c1,000 = LR+ 17.0 and LR- = 0.0) with values always >7 for LR+ and <0.033 for LR- for all CACS classes.

Conclusions: CTCA is a reliable diagnostic modality, with high sensitivity and NPV regardless of CACS.

Citing Articles

Prognostic Value and Therapeutic Perspectives of Coronary CT Angiography: A Literature Review.

Carita P, Guaricci A, Muscogiuri G, Carrabba N, Pontone G Biomed Res Int. 2018; 2018:6528238.

PMID: 30306089 PMC: 6165606. DOI: 10.1155/2018/6528238.

Coronary Atherosclerosis Assessment by Coronary CT Angiography in Asymptomatic Diabetic Population: A Critical Systematic Review of the Literature and Future Perspectives.

Guaricci A, De Santis D, Carbone M, Muscogiuri G, Guglielmo M, Baggiano A Biomed Res Int. 2018; 2018:8927281.

PMID: 29511691 PMC: 5820580. DOI: 10.1155/2018/8927281.

Hybrid SPECT/CT Imaging in the Evaluation of Coronary Stenosis: Role in Diabetic Patients.

Romagnoli A, Schillaci O, Arganini C, Gaspari E, Ricci A, Morosetti D ISRN Radiol. 2014; 2013:419737.

PMID: 24959556 PMC: 4045525. DOI: 10.5402/2013/419737.

Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis.

den Dekker M, De Smet K, de Bock G, Tio R, Oudkerk M, Vliegenthart R Eur Radiol. 2012; 22(12):2688-98.

PMID: 22797978 DOI: 10.1007/s00330-012-2551-x.

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