title: Diagnostic accuracy of Visipaque enhanced coronary computed tomographic angiography: a prospective multicenter trial.
abstract: BACKGROUND
  Although several studies have shown promise for noninvasive angiography by coronary computed tomographic angiography (CCTA), few prospective multicenter trials have been conducted. This study evaluated the diagnostic accuracy of Visipaque enhanced CCTA to detect obstructive coronary stenosis compared with quantitative coronary angiography (QCA).
  
  
  METHODS
  Three sites prospectively enrolled 77 patients (58.1% men, 54 years) with chest pain referred for invasive coronary angiography (ICA). Patients underwent CCTA (Lightspeed VCT/Visipaque 320) before ICA. CCTAs were graded on a 15-segment American Heart Association model by a CCTA core lab with blinded readers for the presence of obstructive stenosis (>50% or >70%); ICAs were independently graded for %stenosis by QCA, considered the reference standard. The efficacy of CCTA was assessed including all vessel segments for per-patient and per-vessel analyses.
  
  
  RESULTS
  A total of 46 more than 50% stenoses in 27 (35%) patients, and 31 more than 70% stenoses in 20 (26%) patients, were identified by QCA. Per-patient and per-vessel efficacy of CCTA compared with QCA yielded sensitivities of 85% and specificities of 90 and 95%, respectively.
  
  
  CONCLUSIONS
  This study shows the high accuracy of CCTA to reliably detect more than 50% and more than 70% stenoses in low-probability to intermediate-probability chest pain patients being referred for ICA. The high negative predictive values observed (92-100%) indicate that CCTA is also an effective noninvasive alternative to exclude obstructive coronary stenosis.
authors.affiliation: aDepartment of Medicine, Los Angeles Biomedical Research Institute, Torrance, California bCardiology Associates, Mobile, Alabama, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.forename: Nove
authors.initials: N
authors.lastname: Kalia
authors.forename: Jason
authors.initials: J
authors.lastname: Cole
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.forename: Negin
authors.initials: N
authors.lastname: Nezarat
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000072226:Computed Tomography Angiography; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014283:Triiodobenzoic Acids; D014481:United States
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol