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Diagnostic accuracy of coronary angiography using 64-slice computed tomography in coronary artery disease
Fu-Bin Yang1, Wan-Liang Guo, Mao Sheng
1Radiology Department, Children's Hospital of Soochow University, Suzhou, People's Republic of China. E-mail. yangfubin123@sina.com.
Insights
64-slice computed tomography (CT) angiography demonstrates high accuracy in detecting coronary artery disease (CAD) in elderly patients. This meta-analysis confirms its reliability for diagnosing coronary artery stenosis (CAS) with a 50% diameter stenosis cut-off.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Accuracy Studies
- Medical Technology Assessment
Background:
- Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
- Accurate and non-invasive diagnostic tools are crucial for timely intervention.
- 64-slice CT angiography offers a potential non-invasive method for CAD assessment.
Purpose of the Study:
- To perform a meta-analysis evaluating the diagnostic value of 64-slice CT angiography for CAD.
- To determine the sensitivity, specificity, and overall accuracy of 64-slice CT angiography in detecting coronary artery stenosis (CAS).
Main Methods:
- A systematic literature search was conducted across multiple databases (Cochrane Library, Medline, EmBase, PubMed, BioMed Central) from March 2005 to August 2014.
- Included studies compared 64-slice CT angiography with invasive coronary angiography as the reference standard for detecting CAS (defined as ≥50% diameter stenosis).
- Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the curve (AUC) from summary receiver operating characteristic (SROC) curves were calculated.
Main Results:
- Eight studies comprising 579 patients and 7,407 coronary vessels were analyzed.
- Pooled sensitivity was 90% and specificity was 91% at the segment level for detecting CAS.
- The area under the curve (AUC) was 0.94, indicating high diagnostic accuracy.
Conclusions:
- 64-slice CT angiography is a reliable tool for diagnosing CAD in the elderly population.
- The diagnostic performance is robust when using a ≥50% diameter stenosis cut-off.
- This imaging modality provides valuable diagnostic information for coronary artery stenosis.
Objectives:
To conduct a meta-analysis and investigate the diagnostic value of 64-slice computed tomography (CT) angiography for diagnosing coronary artery disease (CAD) in patients.
Methods:
A comprehensive literature search from March 2005 to August 2014 was performed on the following databases: Cochrane Library; Medline; EmBase; PubMed; and BioMed Central database. As a reference standard, studies that assessed 64-slice CT angiography in detecting coronary artery stenosis (CAS) with invasive coronary angiography were included. Coronary artery stenosis was defined as ≥50% diameter stenosis. Diagnostic value was determined by pooling sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) values at segment-level analysis. Diagnostic accuracy was undertaken using area under the curve (AUC) value and summary receiver operating characteristic (SROC) curves. Publication bias was examined by Deek's funnel plot asymmetry test.
Results:
Eight studies were included in the analysis, enrolling a total of 579 patients (7,407 segment coronary vessels). At segment-level, pooled sensitivity value was 90% (95% confidence interval [CI]: 83-95%), specificity was 91% (95% CI: 61-98%), PLR value was 9.7 (95% CI: 1.8-53.3), and NLR value was 0.11 (95% CI: 0.05-0.22) for CAS. Optimal cut-off point of sensitivity was 90%, and specificity under the SROC curve was 91%. The AUC value was 0.94.
Conclusion:
The 64-slice CT angiography is a reliable tool for detection of CAD when using a cut-off of more than or equal to 50% diameter stenosis in elderly population.
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