Diagnostic accuracy of computed tomography coronary angiography in patients with a zero calcium score.
To evaluate the diagnostic accuracy of 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in patients with zero on the Agatston Calcium Score (CACS). We enrolled 279 consecutive patients (96 male, mean age 48 +/- 12 years) with suspected coronary artery disease. Patients were symptomatic (n = 208) or asymptomatic (n = 71), and underwent conventional coronary angiography (CAG). For CT-CA we administered an IV bolus of 100 ml of iodinated contrast material. CT-CA was compared to CAG using a threshold for significant stenosis of >or=50%. The prevalence of disease demonstrated at CAG was 15% (1.4% in asymptomatic). The population at CAG showed no or non-significant disease in 85% (238/279), single vessel disease in 9% (25/279), and multi-vessel disease in 6% (16/279). Sensitivity, specificity, and positive and negative predictive values of CT-CA vs. CAG on the patient level were 100%, 95%, 76%, and 100% in the overall population and 100%, 100%, 100%, and 100% in asymptomatic patients, respectively. CT-CA proves high diagnostic performance in patients with or without symptoms and with zero CACS. The prevalence of significant disease detected by CT-CA was not negligible in asymptomatic patients. The role of CT-CA in asymptomatic patients remains uncertain.
Cademartiri
Filippo
F
Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. filippocademartiri@hotmail.com
Maffei
Erica
E
Palumbo
Alessandro
A
Martini
Chiara
C
Seitun
Sara
S
Tedeschi
Carlo
C
De Rosa
Roberto
R
Arcadi
Teresa
T
Salamone
Ignazio
I
Blandino
Alfredo
A
Weustink
Annick C
AC
Mollet
Nico R
NR
De Feyter
Pim J
PJ
Krestin
Gabriel P
GP
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult