Do risk factors influence the diagnostic accuracy of noninvasive coronary angiography with multislice computed tomography?
BACKGROUND
Multislice computed tomography (MSCT) is a relatively new noninvasive imaging modality in the evaluation of patients with suspected coronary artery disease (CAD). Whether diagnostic accuracy is influenced by gender or risk factors for CAD is currently unknown and was evaluated in this study.


RESULTS
In 197 patients (171 men and 26 women; mean age, 60 +/- 11 years) 16-slice MSCT was performed and compared with invasive coronary angiography at 2 different centers (Leiden and Rotterdam, The Netherlands). Diagnostic accuracy for the detection of 50% luminal narrowing or greater was calculated for all patients combined, as well as for patients with known versus suspected CAD. In addition, diagnostic accuracy was determined in men versus women and in different subsets of patients based on the presence of risk factors for CAD including hypertension, type 2 diabetes mellitus, hypercholesterolemia, and obesity. Only segments with a diameter of 2.0 mm or greater were evaluated, whereas smaller segments and stents were excluded from the analysis. Overall, a sensitivity and specificity of 99% and 86%, respectively, on a patient level were demonstrated, with corresponding positive and negative predictive values of 95% and 96%, respectively. Similar values were observed in the different subsets of patients, with no statistical differences.


CONCLUSIONS
These findings confirm the high diagnostic accuracy of MSCT, regardless of gender or risk factors.
Schuijf
Joanne D
JD
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Mollet
Nico R
NR
Cademartiri
Filippo
F
Jukema
J Wouter
JW
Lamb
Hildo J
HJ
de Roos
Albert
A
van der Wall
Ernst E
EE
de Feyter
Pim J
PJ
Bax
Jeroen J
JJ
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*