Multi-slice computed tomography coronary angiography for ruling out suspected coronary artery disease: what is the prevalence of a normal study in a general clinical population?
OBJECTIVE
To assess the prevalence of a normal multi-slice computed tomography (MSCT) in patients with suspected coronary artery disease (CAD) and to relate these observations to clinical presentation and pre-test likelihood of CAD.


RESULTS
In total, 340 consecutive patients (182 men, 55 +/- 12 years) without a history of CAD who were referred for MSCT angiography were included in the study. Based on patient characteristics and the referral reason for MSCT angiography, patients were classified as having a low, intermediate, or high pre-test likelihood of CAD. Patients were evaluated for the presence of coronary artery calcium as well as the presence of atherosclerosis. Overall, 157 (46%) patients did not have coronary artery calcium and 133 (40%) patients had a completely normal MSCT angiogram. In 58% of the patients with low pre-test likelihood, no coronary atherosclerosis was observed when compared with 33 and 17% of the patients with intermediate and high pre-test likelihood, respectively.


CONCLUSIONS
MSCT ruled out coronary atherosclerosis in 40-46% of patients without known CAD who were referred for MSCT. Accordingly, in patients with low-to-intermediate pre-test likelihood, MSCT may be an attractive modality to exclude coronary atherosclerosis and may prevent unnecessary additional functional testing or invasive angiography.
Henneman
Maureen M
MM
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, PO 9600, 2300 RC Leiden, The Netherlands.
Schuijf
Joanne D
JD
van Werkhoven
Jacob M
JM
Pundziute
Gabija
G
van der Wall
Ernst E
EE
Jukema
J Wouter
JW
Bax
Jeroen J
JJ
D017677:Age Distribution; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods*