title: Diagnostic performance of 64-channel multislice computed tomography in assessment of significant coronary artery disease in symptomatic subjects.
abstract: The recent development of 64-channel multislice computed tomography (MSCT) has resulted in noninvasive coronary artery imaging improvement. This study was conducted to determine the accuracy of 64-slice MSCT in a relatively unselected group of 143 patients with presentations suggestive of coronary artery disease, including those with unstable angina pectoris, who underwent both coronary computed tomographic angiography and invasive coronary angiography. No arrhythmia was considered an exclusion criterion except for atrial fibrillation or frequent extrasystoles. In patients with fast heart rates, a beta blocker was administered orally. Data were obtained using electrocardiography gated 64-slice MSCT. Computed tomographic angiography and invasive coronary angiography findings of each coronary segment were compared to determine the sensitivity, specificity, positive predictive value, and negative predictive value of MSCT in the detection of their normalcy or insignificant (<50% diameter decrease) stenosis versus significant (>or=50% diameter decrease) stenosis or total occlusion. In per-patient assessment, the calculated sensitivity, specificity, positive predictive value, and negative predictive value of MSCT were 96%, 67%, 91%, and 83%, respectively. These values in per-artery evaluation were 94%, 94%, 87%, and 97%, and corresponding values in per-segment analysis were 92%, 97%, 77%, and 99%, respectively. In conclusion, computed tomographic angiography has high diagnostic performance in the assessment of significant coronary artery disease in most patients in a daily routine practice, including those presenting with unstable angina pectoris symptoms.
authors.affiliation: Department of Radiology, Shahid Beheshti University of Medical Sciences, and Department of Research and Development, Shariati Hospital, Tehran, Iran. abarjshabestari@taleghanihospital.ir
authors.forename: Abbas Arjmand
authors.initials: AA
authors.lastname: Shabestari
authors.forename: Seifollah
authors.initials: S
authors.lastname: Abdi
authors.forename: Shahram
authors.initials: S
authors.lastname: Akhlaghpoor
authors.forename: Mitra
authors.initials: M
authors.lastname: Azadi
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Baharjoo
authors.forename: Mohammad Danesh
authors.initials: MD
authors.lastname: Pajouh
authors.forename: Zyae
authors.initials: Z
authors.lastname: Emami
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Esfahani
authors.forename: Iraj
authors.initials: I
authors.lastname: Firouzi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Hashemian
authors.forename: Morad
authors.initials: M
authors.lastname: Kouhi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Mozafari
authors.forename: Iraj
authors.initials: I
authors.lastname: Nazeri
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Roshani
authors.forename: Babak
authors.initials: B
authors.lastname: Salevatipour
authors.forename: Hedayatollah
authors.initials: H
authors.lastname: Tavalla
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Tehrai
authors.forename: Ali
authors.initials: A
authors.lastname: Zarrabi
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed