Abstract 2206: Diagnostic accuracy of 64-slice Computed Tomography versus Conventional Coronary Angiography: Results of 180 Consecutive Patients.
Purpose: We sought to compare the diagnostic value of 64-slice CT coronary angiography to detect significant stenoses with that of invasive CA in a large consecutive population.
Methods and materials: 64-slice CT angiography (Siemens, Sensation 64, Germany) was performed in 180 patients (mean age 60.1+/−12.1 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-segment elevation myocardial infarction scheduled for diagnostic conventional CA. Patients who had undergone coronary artery bypass grafting or previous percutaneous coronary intervention were excluded. All patients had stable sinus rhythm. Patients with initial heart rates > or = 70 bpm received beta-blockers and/or lorazepam. Mean scan time was 12.9+/−0.9 seconds. The CT scans were analyzed by 2 observers unaware of the results of invasive coronary angiography, which was used as the standard of reference. All available coronary segments, regardless of size, were included in the evaluation. Lesions with > or = 50 luminal narrowing were considered significant stenoses.
Results: Invasive coronary angiography demonstrated the absence of significant disease in 20% (36 of 180), single-vessel disease in 34.4 % (62 of 180), and multivessel disease in 45.6 % (82 of 180) of patients. Complications were contrast extravasation (n = 1), second degree AV block due to beta blockers (n = 1) and contrast-allergic reactions (n = 2). Sensitivity for detecting significant stenosis on a segment-by-segment analysis was 93%, specificity 96%, and positive and negative predictive values 78% and 98%, respectively.
Conclusions: 64-slice CT angiography reliably detects significant coronary stenoses in patients with a wide variety of clinical presentations.