title: Multislice computed tomography in an asymptomatic high-risk population.
abstract: Approximately 50% of all acute coronary syndromes occur in previously asymptomatic patients. This study evaluated the value of multislice computed tomography for early detection of significant coronary artery disease (CAD) in high-risk asymptomatic subjects. One hundred sixty-eight asymptomatic subjects with >or=1 major risk factor (hypertension, diabetes, hypercholesterolemia, family history, or smoking) and an inconclusive or unfeasible noninvasive stress test result (stress electrocardiography, echocardiography, or nuclear scintigraphy) were evaluated in an outpatient setting. After clinical examination and laboratory risk analysis, all patients underwent multislice computed tomographic (MSCT) coronary angiography within 1 week. In all subjects, conventional coronary angiography was also carried out. Multislice computed tomography displayed single-vessel CAD in 16% of patients, 2-vessel CAD in 7%, and 3-vessel CAD in 4%. Selective coronary angiography confirmed the results of multislice computed tomography in 99% of all patients. Sensitivity and specificity of MSCT coronary angiography were 100% and 98%, respectively, with a positive predictive value of 95% and a negative predictive value of 100%. In conclusion, MSCT coronary angiography is an excellent noninvasive technique for early identification of significant CAD in high-risk asymptomatic patients with inconclusive or unfeasible noninvasive stress test results.
authors.affiliation: Department of Cardiology, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Roberto
authors.initials: R
authors.lastname: Leo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Clementi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Razzini
authors.forename: Mauro
authors.initials: M
authors.lastname: Borzi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Martuscelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Pizzuto
authors.forename: Gaetano
authors.initials: G
authors.lastname: Chiricolo
authors.forename: Jawahar L
authors.initials: JL
authors.lastname: Mehta
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013577:Syndrome; D014057:Tomography, X-Ray Computed