Coronary artery disease (CAD) is a serious, chronic and progressive disease in which invasive and non-invasive methods of imaging play a crucial role in diagnosis and treatment of the disease. The aim of the study is to compare findings of non-invasive diagnostic methods such as coronary computed tomography angiography (CCTA), single photon emission computed tomography scan (SPECT), stress ECG, stress ECHO, Cardiac Magnetic Resonance Imaging (CMR) and positron emission tomography (PET) with the gold standard method of invasive coronary angiography (ICA) in 101 patients diagnosed with chronic coronary syndromes (CCS). This was an observational study of patients with CCS who had undergone one or more non-invasive methods and subsequently underwent ICA. Correlations between the findings of non-invasive methods and ICA were performed. A total of 101 patients were included (mean age of the population was 64±10 years and 82% of the participants were men, 57% of the patients underwent CCTA, 44% underwent SPECT and 9% underwent both studies). CCTA was defined as positive when a stenosis ≥50% was detected. As for SPECT, we set two cut offs, one where any myocardium ischemia was taken as positive and a second where we defined SPECT as positive when an ischemia ≥10% of myocardium was detected. Sensitivity was 100% for CCTA, 82% for SPECT (any ischemia) and 47% for SPECT with ≥10% ischemia. Whereas specificity was 35% for CCTA, 31% for SPECT (any ischemia) and 67% for SPECT with 10%. Positive predictive value (PPV) was 79% for CCTA, 76% for SPECT with any ischemia and 79% for SPECT 10%, while negative predictive value (NPV) was 100% for CCTA, 40% for any ischemia SPECT and 32% for SPECT ≥10% Lastly, accuracy was calculated at 81% for CCTA, 68% for SPECT and 52% for SPECT positive for ≥10% ischemia. In conclusion, our study showed relatively similar results of CCTA and SPECT (positive for any ischemia) sensitivity to other studies. Specificity of the methods mentioned above showed no similarities. SPECT positive for myocardial ischemia ≥10%, showed similar sensitivity and specificity with one study. The diagnostic accuracy of CCTA and SPECT in our study didn’t differ from other studies’ diagnostic accuracy.
Χρήστος Γ. Μποζίνης (Wed,) studied this question.