Why the study?
Evidence supporting CCTA as a first-line pre-operative coronary assessment strategy over ICA in valve surgery patients with low-to-moderate CAD risk remains uncertain.
Does coronary computed tomography angiography (CCTA) compared to invasive coronary angiography (ICA) provide adequate diagnostic accuracy and similar clinical outcomes in valve surgery patients?
Comparison
Pre-operative CCTA vs ICA
Design
Systematic review and meta-analysis of observational studies
Follow-up
Median 31.7 months
Key result
Pre-operative CCTA showed 86% sensitivity and 87% specificity for CAD, with no significant difference in late MACE compared to ICA (IRR 1.16; 95% CI 0.15-8.96; P=0.52).
Authors
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Supports CCTA-first strategy in low-moderate risk valve surgery patients; confirms high diagnostic accuracy and extends guideline evidence.
Meta-Analysis (n=5,781)
Does coronary computed tomography angiography (CCTA) compared to invasive coronary angiography (ICA) provide adequate diagnostic accuracy and similar clinical outcomes in valve surgery patients?
Effect estimate: IRR 1.16 (95% CI 0.15-8.96)
p-value: p=0.52
CCTA demonstrates high diagnostic accuracy and similar clinical outcomes compared to ICA, supporting its use as a rule-out strategy for coronary artery disease before elective valve surgery.
Sun et al. (2026) conducted a meta-analysis in valve surgery patients with low-moderate risk of coronary artery disease (CAD) (n=5,781). Coronary computed tomography angiography (CCTA) vs. Invasive coronary angiography (ICA) was evaluated on Per-patient diagnostic accuracy and late major adverse cardiovascular events (MACE) (IRR 1.16, 95% CI 0.15-8.96, p=0.52). Pre-operative CCTA showed 86% sensitivity and 87% specificity for CAD, with no significant difference in late MACE compared to ICA (IRR 1.16; 95% CI 0.15-8.96; P=0.52).