Key result
320-row CTA detects significant coronary stenosis with 100% sensitivity compared to invasive angiography.
Why the study?
320-row multidetector computed tomography coronary angiography (CTA) is a new imaging modality with 16 cm coverage allowing single heartbeat acquisition, but its diagnostic accuracy for significant CAD needed assessment.
Does 320-row CTA accurately detect significant coronary artery disease compared to invasive coronary angiography in patients with known or suspected CAD?
Cross-Sectional (n=64)
Blinded
Does 320-row CTA accurately detect significant coronary artery disease compared to invasive coronary angiography in patients with known or suspected CAD?
Effect estimate: Sensitivity 100%, Specificity 88%
320-row CTA demonstrates high diagnostic accuracy for detecting significant coronary artery disease compared to invasive coronary angiography.
Supports non-invasive CAD assessment with 320-row CTA; leaves open whether high accuracy reduces invasive procedures or improves outcomes in practice.
AIMS: Multidetector computed tomography coronary angiography (CTA) has emerged as a feasible imaging modality for non-invasive assessment of coronary artery disease (CAD). Recently, 320-row CTA systems were introduced, with 16 cm anatomical coverage, allowing image acquisition of the entire heart within a single heart beat. The aim of the present study was to assess the diagnostic accuracy of 320-row CTA in patients with known or suspected CAD. METHODS AND RESULTS: A total of 64 patients (34 male, mean age 61 +/- 16 years) underwent CTA and invasive coronary angiography. All CTA scans were evaluated for the presence of obstructive coronary stenosis by a blinded expert, and results were compared with quantitative coronary angiography. Four patients were excluded from initial analysis due to non-diagnostic image quality. Sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 88, 92, and 100%, respectively. Moreover, sensitivity, specificity, and positive and negative predictive values to detect > or =70% luminal narrowing on a patient basis were 94, 95, 88, and 98%, respectively. With inclusion of non-diagnostic imaging studies, sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 81, 88, and 100%, respectively. CONCLUSION: The current study shows that 320-row CTA allows accurate non-invasive assessment of significant CAD.
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Graaf et al. (2010) conducted a cross-sectional in known or suspected coronary artery disease (n=64). 320-row multidetector computed tomography coronary angiography vs. invasive quantitative coronary angiography was evaluated on detection of ≥50% luminal narrowing on a patient basis (Sensitivity 100%, Specificity 88%). 320-row computed tomography coronary angiography accurately detected ≥50% luminal narrowing with 100% sensitivity and 88% specificity compared to invasive coronary angiography.
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