Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease.
OBJECTIVE
To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.


RESULTS
A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the chi(2) test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78-97%) and 83% (30 of 36 patients, 95%CI 67-94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57-85%) and 31% (11 of 36 patients, 95%CI 16-48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3-16%) vs. 19% (15 of 80 patients, 95%CI 11-29%)].


CONCLUSIONS
In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.
Dewey
Marc
M
Department of Radiology, Medical School, Humboldt-Universität zu Berlin, Germany. marc.dewey@charite.de
Dübel
Hans-Peter
HP
Schink
Tania
T
Baumann
Gert
G
Hamm
Bernd
B
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*