title: Computed tomography coronary angiography in asymptomatic patients.
abstract: OBJECTIVE
  This study assessed the accuracy of computed tomography coronary angiography (CT-CA) for detecting significant coronary artery disease (CAD; ≥50% lumen reduction) in intermediate/high-risk asymptomatic patients.
  
  
  METHODS
  A total of 183 consecutive asymptomatic individuals (92 men; mean age 54±11 years) with more than one major risk factor (obesity, hypertension, diabetes, hypercholesterolaemia, family history, smoking) and an inconclusive or nonfeasible noninvasive stress test result (stress electrocardiography, stress echocardiography, nuclear stress scintigraphy) underwent CT-CA in an outpatient setting. All patients underwent conventional coronary angiography (CAG) within 4 weeks. Data from CT-CA were compared with CAG regarding the presence of significant CAD (≥50% lumen reduction).
  
  
  RESULTS
  Mean calcium score was 177±432, mean heart rate during the CT-CA scan was 58±8 bpm and the prevalence (per-patient) of obstructive CAD was 19%. CT-CA showed single-vessel CAD in 9% of patients, two-vessel CAD in 9% and three-vessel CAD in 0%. Per-patient sensitivity, specificity, positive predictive value and negative predictive value of CT-CA were 100% (90-100), 98% (96-99), 97% (85-99), 100% (97-100), respectively. Positive and negative likelihood ratios were 151 and 0, respectively.
  
  
  CONCLUSIONS
  CT-CA is an excellent noninvasive imaging modality for excluding significant CAD in intermediate/ high-risk asymptomatic patients with inconclusive or nonfeasible noninvasive stress test.
authors: Department of Radiology and Cardiology, c/o Piastra Tecnica, Piano 0, Azienda Ospedaliero-Universitaria, Via Gramsci 14, 43100, Parma, Italy.
authors: E
authors: E
authors: Maffei
authors: A
authors: A
authors: Palumbo
authors: C
authors: C
authors: Martini
authors: C
authors: C
authors: Tedeschi
authors: T
authors: T
authors: Arcadi
authors: L
authors: L
authors: La Grutta
authors: R
authors: R
authors: Malagò
authors: A C
authors: AC
authors: Weustink
authors: N R
authors: NR
authors: Mollet
authors: R
authors: R
authors: De Rosa
authors: O
authors: O
authors: Catalano
authors: I
authors: I
authors: Salamone
authors: A
authors: A
authors: Blandino
authors: M
authors: M
authors: Midiri
authors: F
authors: F
authors: Cademartiri
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012802:Sicily / Q000453:epidemiology; D014057:Tomography, X-Ray Computed