Diagnostic Performance of 64-Channel Multislice Computed Tomography in Assessment of Significant Coronary Artery Disease in Symptomatic Subjects

• Published in: The American journal of cardiology Vol. 99; no. 12; pp. 1656 - 1661
• Main Authors: Shabestari, Abbas Arjmand, MD, Abdi, Seifollah, MD, Akhlaghpoor, Shahram, MD, Azadi, Mitra, MD, Baharjoo, Hamidreza, MD, Pajouh, Mohammad Danesh, MD, Emami, Zyae, MD, Esfahani, Fatemeh, MD, MPH, Firouzi, Iraj, MD, Hashemian, Mahmoud, MD, Kouhi, Morad, MD, Mozafari, Mahmoud, MD, Nazeri, Iraj, MD, Roshani, Mahmoud, MD, Salevatipour, Babak, MD, Tavalla, Hedayatollah, MD, Tehrai, Mahmoud, MD, Zarrabi, Ali, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-06-2007; Elsevier; Elsevier Limited
• Subjects: Accuracy; Aged; Angina pectoris; Angina, Unstable - diagnostic imaging; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary heart disease; Coronary vessels; Female; Heart; Human subjects; Humans; Male; Medical imaging; Medical sciences; Middle Aged; Prospective Studies; Tomography; Tomography, X-Ray Computed; Performance evaluation; Human; Radiodiagnosis; Cardiovascular disease; Ionic channel; Coronary heart disease; Medical imagery; Multislice; Computerized axial tomography; Circulatory system; Diagnosis; Cardiology; Performance
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2007.01.040

The recent development of 64-channel multislice computed tomography (MSCT) has resulted in noninvasive coronary artery imaging improvement. This study was conducted to determine the accuracy of 64-slice MSCT in a relatively unselected group of 143 patients with presentations suggestive of coronary artery disease, including those with unstable angina pectoris, who underwent both coronary computed tomographic angiography and invasive coronary angiography. No arrhythmia was considered an exclusion criterion except for atrial fibrillation or frequent extrasystoles. In patients with fast heart rates, a β blocker was administered orally. Data were obtained using electrocardiography gated 64-slice MSCT. Computed tomographic angiography and invasive coronary angiography findings of each coronary segment were compared to determine the sensitivity, specificity, positive predictive value, and negative predictive value of MSCT in the detection of their normalcy or insignificant (<50% diameter decrease) stenosis versus significant (≥50% diameter decrease) stenosis or total occlusion. In per-patient assessment, the calculated sensitivity, specificity, positive predictive value, and negative predictive value of MSCT were 96%, 67%, 91%, and 83%, respectively. These values in per-artery evaluation were 94%, 94%, 87%, and 97%, and corresponding values in per-segment analysis were 92%, 97%, 77%, and 99%, respectively. In conclusion, computed tomographic angiography has high diagnostic performance in the assessment of significant coronary artery disease in most patients in a daily routine practice, including those presenting with unstable angina pectoris symptoms.