title: Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: meta analysis.
abstract: OBJECTIVE
  To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF).
  
  
  METHODS
  We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data.
  
  
  RESULTS
  The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6-10.1) and 0.03(CI, 0.004-0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8-23.9] and 0.1 [CI, 0.07-0.3]; 25.1 [CI, 10.8-58.5] and 0.2 [CI, 0.2-0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02.
  
  
  CONCLUSIONS
  Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels.
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China. cjr.sungang@vip.163.com
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.forename: Zhi-wei
authors.initials: ZW
authors.lastname: Jiang
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.forename: Zhao-hui
authors.initials: ZH
authors.lastname: Peng
authors.forename: Juan
authors.initials: J
authors.lastname: Ding
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Zhi-tao
authors.initials: ZT
authors.lastname: Jin
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D006801:Humans; D015995:Prevalence; D015900:Radiography, Dual-Energy Scanned Projection / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
keywords: Angiography; Atrial fibrillation; Computed tomography; Coronary; Diagnosis