Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris.
OBJECTIVE
This study was designed to prospectively evaluate the diagnostic performance of multislice spiral computed tomography (MSCT) coronary angiography for the detection of significant lesions in all segments of the coronary tree potentially suitable for revascularization.


BACKGROUND
Noninvasive MSCT coronary angiography is a promising coronary imaging technique.


METHODS
Sixteen-row MSCT coronary angiography was performed in 128 patients (89% men, mean age 58.9 +/- 11.7 years) in sinus rhythm with stable angina pectoris scheduled for conventional coronary angiography. Sixty percent (77 of 128) of patients received pre-scan oral beta-blockers, resulting in a mean heart rate of 57.7 +/- 7.7 beats/min. The diagnostic performance of MSCT for detection of significant lesions (> or =50% diameter reduction) was compared with that of quantitative coronary angiography (QCA).


RESULTS
The sensitivity of MSCT for detection of significant lesions was 92% (216 of 234, 95% confidence interval [CI]: 88 to 95). Specificity was 95% (1,092 of 1,150, 95% CI: 93 to 96), positive predictive value 79% (216 of 274, 95% CI: 73 to 88), and negative predictive value 98% (1,092 of 1,110, 95% CI: 97 to 99). Two > or =50% lesions were missed because of motion artifacts and two because of severe coronary calcifications. The rest (78%, 14 of 18) were detected but incorrectly classified as <50% obstructions. All patients with and 86% (18 of 21) of patients without significant lesions on QCA were correctly classified by MSCT. All patients with significant left main disease or total occlusions were correctly identified on MSCT.


CONCLUSIONS
Sixteen-row MSCT coronary angiography permits reliable detection of significant obstructive coronary artery disease in patients with stable angina in sinus rhythm.
Mollet
Nico R
NR
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
Cademartiri
Filippo
F
Nieman
Koen
K
Saia
Francesco
F
Lemos
Pedro A
PA
McFadden
Eugene P
EP
Pattynama
Peter M T
PM
Serruys
Patrick W
PW
Krestin
Gabriel P
GP
de Feyter
Pim J
PJ
D000368:Aged; D000787:Angina Pectoris / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology; D003331:Coronary Vessels / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods / Q000592:standards