What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Atrial fibrillation (n=60). Intervention: Dual-source computed tomography (DSCT) vs. Invasive coronary angiography. Primary outcome: Detection of significant coronary stenoses (≥50% diameter reduction) on a per-patient basis (Sensitivity 100%, 95% CI 77-100).

What question did this study set out to answer?

To evaluate the sensitivity, specificity, and predictive values of dual-source computed tomography for detecting significant coronary artery stenoses in patients with atrial fibrillation.

July 11, 2010European Heart JournalOpen Access

Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography

Q: What does this research mean for the field?

Dual-source computed tomography demonstrates high diagnostic accuracy with 100% sensitivity and 85% specificity for detecting significant coronary artery disease in selected patients with rate-controlled atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

View Full Paper

Ask AI

Bookmark

Key result

DSCT achieves 100% sensitivity for detecting significant CAD in patients with AF.

Sensitivity 100%
95% CI 77-100
n=60

Why the study?

Regular sinus rhythm has been considered a prerequisite for adequate multislice CT examination, but atrial fibrillation is common among patients evaluated for coronary heart disease, creating uncertainty about CT accuracy in AF patients.

Does dual-source computed tomography accurately identify significant coronary artery disease compared to invasive coronary angiography in patients with rate-controlled atrial fibrillation?

Key Points

To evaluate the sensitivity, specificity, and predictive values of dual-source computed tomography for detecting significant coronary artery stenoses in patients with atrial fibrillation.
Screened 110 consecutive patients with atrial fibrillation referred for initial diagnostic coronary angiography, ultimately evaluating 60 rate-controlled patients (mean age 71 ± 7 years; mean heart rate 70 ± 15 bpm) after excluding 50 due to renal failure, breath-hold limitations, or heart rates >100 bpm.
Performed dual-source CT angiography with retrospective ECG gating within 24 hours prior to invasive coronary angiography, defining significant stenosis as ≥50% lumen diameter reduction.
On a per-patient basis, dual-source CT showed a sensitivity of 100% (14/14, 95% CI 77–100), specificity of 85% (39/46, 95% CI 71–94), negative predictive value of 100% (39/39, 95% CI 91–100), and positive predictive value of 67% (14/21, 95% CI 43–85).
On a per-artery basis across 240 vessels, sensitivity was 95% (21/22, 95% CI 77–100), specificity was 94% (204/218, 95% CI 89–97), negative predictive value was 99% (204/205, 95% CI 96–100), and positive predictive value was 60% (21/35, 95% CI 38–80).

Study Design

Type

Cross-Sectional (n=60)

Structured PICO

Does dual-source computed tomography accurately identify significant coronary artery disease compared to invasive coronary angiography in patients with rate-controlled atrial fibrillation?

Population

60 patients with rate-controlled atrial fibrillation referred for a first diagnostic coronary angiogram, evaluated for significant coronary artery disease.

Exposure

Dual-source computed tomography (DSCT) angiography

Comparator

Invasive coronary angiography (reference standard)

Outcome

Diagnostic accuracy (sensitivity, specificity, negative predictive value, positive predictive value) for detecting significant coronary stenoses (≥50% diameter reduction)surrogate

Main Result

Effect estimate: Sensitivity 100% (95% CI 77-100)

Dual-source computed tomography provides high sensitivity and negative predictive value for ruling out significant coronary artery disease in selected patients with rate-controlled atrial fibrillation.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

DSCT may support CAD rule-out in selected rate-controlled AF; leaves open need for larger prospective validation before wider use.

Cite This Study

Marwan et al. (2010) conducted a cross-sectional in Atrial fibrillation (n=60). Dual-source computed tomography (DSCT) vs. Invasive coronary angiography was evaluated on Detection of significant coronary stenoses (≥50% diameter reduction) on a per-patient basis (Sensitivity 100%, 95% CI 77-100). Dual-source computed tomography showed 100% sensitivity (95% CI 77-100) and 85% specificity (95% CI 71-94) for detecting significant coronary artery disease in patients with atrial fibrillation.

synapsesocial.com/papers/6aaf7a508fea992f1939a084 https://doi.org/10.1093/eurheartj/ehq223

Topics

Atrial fibrillation Persistent AF management Coronary artery disease Anticoagulation in AF

View Full Paper

Ask AI

Bookmark

Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider