TY - JOUR
T1 - The diagnostic accuracy of 256-row computed tomographic angiography compared with invasive coronary angiography in patients with suspected coronary artery disease
AU - Chao, Shu Ping
AU - Law, Wai Yip
AU - Kuo, Chu Jen
AU - Hung, Huei Fong
AU - Cheng, Jun Jack
AU - Lo, Huey Ming
AU - Shyu, Kou Gi
N1 - Funding Information:
This patient had a normal global ejection fraction (75%), absence of regional wall motion abnormalities, and mild systolic anterior motion of the mitral valve without obstruction to LV outflow; coronary arteries were normally positioned at their origins from the aorta. The myocardial crypt was not visualized in standard echocardiographic cross-sectional planes. ECG showed narrow deep Q-waves in II, III, AVF, V3–V6, and delayed progression of precordial R-waves, with diminished or absent R-wave in V1–V3, a not uncommon pattern in HCM. Commercial genetic testing was negative for nine sarcomere genes known to be disease-causing for HCM, as well as LAMP2, PRKAG2, and Fabry disease, a result that occurs in 50% of patients with clinically diagnosed HCM. Funding: This work was supported in part by a grant from The Hearst Foundations, New York, NY.
PY - 2010/8
Y1 - 2010/8
N2 - Aims To assess the diagnostic accuracy of 256-row computed tomographic angiography (CTA) in patients with suspected coronary artery disease (CAD). Non-invasive imaging of the coronary artery by CTA has increasingly been used in recent years. The accuracy of 256-row CTA has not yet been studied. We sought to assess the accuracy of 256-row CTA compared with invasive coronary angiography (ICA) in the diagnosis and assessment of CAD. Methods and resultsWe prospectively evaluated 104 consecutive individuals who accepted CTA and then underwent ICA. The presence of stenosis ≥50 was considered obstructive. The diagnostic accuracy of CTA for detecting obstructive stenosis was compared with that of ICA. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of CTA relative to ICA. A total of 86 patients had obstructive CAD. The patient-based analysis of CTA for detecting stenosis ≥50 according to ICA revealed an AUC of 0.744 [95 confidence interval (CI), 0.572-0.916], with a sensitivity of 98.8, a specificity of 50, a positive predictive value (PPV) of 92.4, and a negative predictive value (NPV) of 87.5. The segment-based analysis revealed an AUC of 0.915 (95 CI, 0.847-0.982), with a sensitivity of 93.5, a specificity of 95, a PPV of 77.6, and an NPV of 98.7. The vessel-based analysis revealed an AUC of 0.887 (95 CI, 0.808-0.966), with a sensitivity of 94.3, a specificity of 87.3, a PPV of 82.7, and an NPV of 95.9. Conclusion 256-Row CTA is a highly sensitive test of CAD and has a high predictive value. 256-Row CTA may be a potential alternative to detect coronary artery stenosis and rule out CAD in suspected patients.
AB - Aims To assess the diagnostic accuracy of 256-row computed tomographic angiography (CTA) in patients with suspected coronary artery disease (CAD). Non-invasive imaging of the coronary artery by CTA has increasingly been used in recent years. The accuracy of 256-row CTA has not yet been studied. We sought to assess the accuracy of 256-row CTA compared with invasive coronary angiography (ICA) in the diagnosis and assessment of CAD. Methods and resultsWe prospectively evaluated 104 consecutive individuals who accepted CTA and then underwent ICA. The presence of stenosis ≥50 was considered obstructive. The diagnostic accuracy of CTA for detecting obstructive stenosis was compared with that of ICA. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of CTA relative to ICA. A total of 86 patients had obstructive CAD. The patient-based analysis of CTA for detecting stenosis ≥50 according to ICA revealed an AUC of 0.744 [95 confidence interval (CI), 0.572-0.916], with a sensitivity of 98.8, a specificity of 50, a positive predictive value (PPV) of 92.4, and a negative predictive value (NPV) of 87.5. The segment-based analysis revealed an AUC of 0.915 (95 CI, 0.847-0.982), with a sensitivity of 93.5, a specificity of 95, a PPV of 77.6, and an NPV of 98.7. The vessel-based analysis revealed an AUC of 0.887 (95 CI, 0.808-0.966), with a sensitivity of 94.3, a specificity of 87.3, a PPV of 82.7, and an NPV of 95.9. Conclusion 256-Row CTA is a highly sensitive test of CAD and has a high predictive value. 256-Row CTA may be a potential alternative to detect coronary artery stenosis and rule out CAD in suspected patients.
KW - 256-Row computed tomography
KW - Computed tomographic angiography
KW - Invasive coronary angiography
KW - Multi-detector computed tomography
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U2 - 10.1093/eurheartj/ehq072
DO - 10.1093/eurheartj/ehq072
M3 - Article
C2 - 20233790
AN - SCOPUS:77953498744
SN - 0195-668X
VL - 31
SP - 1916
EP - 1923
JO - European Heart Journal
JF - European Heart Journal
IS - 15
ER -