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Diagnostic accuracy of coronary computed tomography angiography in ischemic workup of heart failure: a meta-analysis

Nidhish Tiwari1, Sanjana Nagraj1, Andreas Tzoumas2

  • 1Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, The Bronx, NY 10461, USA.

Future Cardiology
|February 4, 2022
PubMed

Insights

Coronary computed tomography angiography (CCTA) accurately diagnoses coronary artery disease in heart failure with reduced ejection fraction (HFrEF). This meta-analysis shows CCTA is a reliable tool for evaluating HFrEF causes.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Accuracy

Background:

  • Heart failure with reduced ejection fraction (HFrEF) has multiple potential etiologies.
  • The diagnostic role of coronary computed tomography angiography (CCTA) in identifying coronary artery disease as a cause of HFrEF requires further clarification.

Purpose of the Study:

  • To assess the pooled diagnostic accuracy of CCTA in detecting significant coronary artery disease (CAD) in patients with newly diagnosed HFrEF.
  • To evaluate CCTA's effectiveness in determining the etiology of HFrEF.

Main Methods:

  • A systematic literature search was performed across electronic databases for relevant studies.
  • A meta-analysis using a random-effects model was conducted on studies comparing CCTA with invasive coronary angiography in HFrEF patients.
  • Patient-based and segment-based analyses were performed to determine diagnostic performance.

Main Results:

  • Five studies with a total of 269 patients were included in the meta-analysis.
  • Patient-based analysis demonstrated high pooled sensitivity (0.99) and specificity (0.94) for CCTA in diagnosing significant CAD.
  • Segment-based analysis showed pooled sensitivity of 0.74 and specificity of 0.99.

Conclusions:

  • Coronary computed tomography angiography exhibits excellent diagnostic accuracy for significant coronary artery disease in patients with newly diagnosed HFrEF.
  • CCTA is a valuable non-invasive tool for evaluating the etiology of HFrEF, particularly ruling out obstructive CAD.

Keywords:
coronary angiographycoronary artery diseasecoronary computed tomography angiographyheart failureischemic cardiomyopathy

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