Diagnostic accuracy of 64-slice computed tomography coronary angiography in a large population of patients without revascularisation: registry data in NSTEMI acute coronary syndrome and influence of gender and risk factors

Purpose This study sought to evaluate the diagnostic accuracy of computed tomography coronary angiography (CTCA) for detecting significant coronary artery stenosis (≥50% lumen reduction) compared with conventional coronary angiography (CAG) in non-ST-elevation myocardial infarction-acute coronary sy...

Full description

Saved in:
Bibliographic Details
Published in:Radiologia medica 2011-10, Vol.116 (7), p.1014-1026
Main Authors: Maffei, E., Martini, C., Tedeschi, C., Spagnolo, P., Zuccarelli, A., Arcadi, T., Guaricci, A., Seitun, S., Weustink, A. C., Mollet, N. R., Cademartiri, F.
Format: Article
Language:eng ; ita
Subjects:
Acute Coronary Syndrome - diagnostic imaging
Age Factors
Aged
Angiography
Cardiac Radiology
Cardioradiologia
Computed tomography
Coronary Angiography
coronary artery
Coronary Stenosis - diagnosis
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - epidemiology
Data processing
Diagnostic Radiology
Female
Humans
Imaging
Interventional Radiology
Italy - epidemiology
Male
Medicine
Medicine & Public Health
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Revascularization - methods
Neuroradiology
Odds Ratio
Predictive Value of Tests
Prevalence
Radiology
Risk Assessment
Risk Factors
Sensitivity and Specificity
Sex Distribution
Sex Factors
Stenosis
Tomography, X-Ray Computed
Ultrasound
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose This study sought to evaluate the diagnostic accuracy of computed tomography coronary angiography (CTCA) for detecting significant coronary artery stenosis (≥50% lumen reduction) compared with conventional coronary angiography (CAG) in non-ST-elevation myocardial infarction-acute coronary syndrome (NSTEMI-ACS) and in subgroups selected by gender and number of risk factors (RF). Materials and methods We selected from a population of 1,500 patients in a multicentre registry with NSTEMI-ACS who had undergone CTCA and CAG, (n=237; 187 men, mean age 63±10 years). Diagnostic accuracy and likelihood ratios (LR) of CTCA were assessed against CAG in the total population and subgroups (men, women: 0 RF = absence of RF, 1–2 RF = presence of one or two RF, >2 RF = presence of more than two RF). Results The prevalence of obstructive disease was 53%. In the per-patient analysis, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CTCA were 100% (men 100%; women 100%; 0 RF 100%; 1–2 RF 100%; >2 RF 100%), 95% (men 98%; women 50%; 0 RF NA% ( NA , not assessable); 1–2 RF 96%; >2 RF 96%), 95% (men 98%; women 91%; 0 RF 91%; 1–2 RF 96%; >2 RF 96%), 100% (men 100%; women 100%; 0 RF NV%; 1–2 RF 100%; >2 RF 100%), respectively. The per-segment analysis showed a reduction in PPV (ranging between 56% and 67%). The per-patient LR+ ranged between 18 and 27, whereas LR-were always 0. We observed no significant differences in diagnostic accuracy between subgroups. Conclusions CTCA is a reliable diagnostic modality with high sensitivity and NPV in NSTEMI-ACS patients who are not candidates for early revascularisation, regardless of gender and number of risk factors.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-011-0696-3