The diagnostic accuracy of 256-row computed tomographic angiography compared with invasive coronary angiography in patients with suspected coronary artery disease

Shu Ping Chao, Wai Yip Law, Chu Jen Kuo, Huei Fong Hung, Jun Jack Cheng, Huey Ming Lo, Kou Gi Shyu

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1916-1923
Number of pages8
JournalEuropean Heart Journal
Volume31
Issue number15
DOIs
Publication statusPublished - Aug 2010

Keywords

  • 256-Row computed tomography
  • Computed tomographic angiography
  • Invasive coronary angiography
  • Multi-detector computed tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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