title: Diagnostic accuracy of 64-slice computed tomography coronary angiography in a large population of patients without revascularisation: registry data on the comparison between male and female population.
abstract: OBJECTIVE
  This study was undertaken to evaluate the diagnostic accuracy of computed tomography coronary angiography (CTCA) for detecting significant coronary artery stenosis (≥50% lumen reduction) compared with conventional coronary angiography (CAG) in a male and female population.
  
  
  METHODS
  A total of 1,372 patients (882 men, 490 women; mean age 59.3 ± 11.9 years) in sinus rhythm imaged with CTCA (64-slice technology) and CAG were enrolled. Diagnostic accuracy and likelihood ratios (LR+ and LR-) of CTCA were assessed against CAG for the male and female populations.
  
  
  RESULTS
  The prevalence of obstructive disease was 53% (men 58%; women 43%). CAG demonstrated the absence of significant coronary artery disease (CAD) in 47% (men 42%; women 56%), single-vessel disease in 25% (men 36%; women 22%) and multivessel disease in 29% (men 32%; women 23%) of patients. In the per-patient analysis, sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of CTCA were 99% (men 98%; women 100%), 92% (men 92%; women 92%), 94% (men 95%; women 90%) and 99% (men 98%; women 100%), respectively. The per-patient likelihood ratios (LR) in the total population (LR+=12.4 and LR-=0.011), the male (LR+=12.9 and LR-=0.016) and female (LR =11.9 and LR-=0) populations were very good. We observed no significant differences in diagnostic accuracy between male and female populations.
  
  
  CONCLUSIONS
  CTCA is a reliable diagnostic modality with high sensitivity and NPV in the female population.
authors.affiliation: Dipartimento di Radiologia e del Cardio-Polmonare, Azienda Ospedaliero-Universitaria di Parma, c/o Piastra Tecnica - Piano 0, Via Gramsci 14, 43100, Parma, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Maffei
authors.forename: C
authors.initials: C
authors.lastname: Martini
authors.forename: C
authors.initials: C
authors.lastname: Tedeschi
authors.forename: P
authors.initials: P
authors.lastname: Spagnolo
authors.forename: A
authors.initials: A
authors.lastname: Zuccarelli
authors.forename: T
authors.initials: T
authors.lastname: Arcadi
authors.forename: A
authors.initials: A
authors.lastname: Guaricci
authors.forename: S
authors.initials: S
authors.lastname: Seitun
authors.forename: A
authors.initials: A
authors.lastname: Weustink
authors.forename: N
authors.initials: N
authors.lastname: Mollet
authors.forename: F
authors.initials: F
authors.lastname: Cademartiri
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*