Multislice cardiac computed tomography in symptomatic middle-aged women.
OBJECTIVE
To assess the accuracy of multislice cardiac computed tomography (MSCT) for detection of significant coronary artery disease (CAD) in middle-aged symptomatic women.


METHODS
We included 70 women (51+/-8 years) with complaints of chest pain or dyspnea, and an abnormal maximum exercise electrocardiogram (ECG) (8.6+/-1.4 metabolic equivalents). All had a MSCT using a 16 detector rows scanner, and coronary arteriography (CA). Blinded results of the two modalities were compared using a segment, vessel, and patient-based analysis.


RESULTS
On MSCT 36% had normal coronaries, 24% had significant CAD requiring revascularization, and the remainder had mild CAD. MSCT had reasonably high diagnostic accuracy at segment level (negative predictive value of 95%, positive predictive value 81%, specificity 99%, and sensitivity 50%), regarding single or multivessel CAD when both nonassessable and assessable segments were included in the analysis. The agreement between the segments comparing MSCT and CA for significant CAD was excellent at 98% (kappa value 0.89).


CONCLUSIONS
In this cohort of middle-aged symptomatic women with an abnormal stress test, 24% had significant CAD requiring intervention. MSCT was highly accurate in diagnosing significant CAD with an excellent negative predictive value.
Shivalkar
Bharati
B
Department of Cardiology, University Hospital Antwerp, Belgium. Bharati.shivalkar@skynet.be
Goovaerts
Inge
I
Salgado
Rodrigo A
RA
Ozsarlak
Ozkan
O
Bosmans
Johan
J
Parizel
Paul M
PM
Vrints
Christiaan J M
CJ
D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000209:etiology; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004417:Dyspnea; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D036542:Tomography, Spiral Computed / Q000379:methods*