Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Diagnostic Cardiology

Background:

• Atrial fibrillation (AF) is common in patients undergoing evaluation for coronary heart disease.
• Regular sinus rhythm is often considered necessary for accurate multislice CT scans.
• Dual-source CT (DSCT) offers potential advantages for cardiac imaging in irregular heart rhythms.

Purpose of the Study:

• To evaluate the sensitivity and specificity of DSCT for detecting significant coronary artery disease (CAD).
• To assess the diagnostic accuracy of DSCT in patients with AF.
• To determine if DSCT can reliably rule out coronary stenoses in patients with AF.

Main Methods:

• Sixty patients with AF referred for invasive coronary angiography were included.
• DSCT angiography was performed within 24 hours prior to invasive coronary angiography.
• Data sets were analyzed for significant coronary stenoses (≥50% diameter reduction) and validated against invasive results.

Main Results:

• On a per-patient basis, DSCT showed 100% sensitivity and 85% specificity for significant CAD, with a 100% negative predictive value.
• On a per-artery basis, DSCT achieved 95% sensitivity and 94% specificity, with a 99% negative predictive value.
• The technique proved effective in selected patients with rate-controlled AF.

Conclusions:

• DSCT demonstrates high sensitivity, specificity, and negative predictive value for detecting significant CAD in patients with AF.
• DSCT is a valuable tool for diagnosing coronary artery disease in patients with AF.
• The findings support the use of DSCT in this patient population, even with irregular heart rhythms.