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Dual-source computed tomography angiography for diagnosis and assessment of coronary artery disease: Systematic review and meta-analysis.
MedLine Citation:
PMID:  22226727     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Development of an accurate test for noninvasive assessment of coronary arteries has been highly desirable. OBJECTIVES: We performed a systematic review of diagnostic accuracy of the dual-source computed tomography (DSCT) in the diagnosis of coronary artery disease (CAD). METHODS: Eight medical databases were searched for articles published from January 2005 through March 2011. Studies compared DSCT coronary angiography (DSCT-CA) and invasive coronary angiography, as the reference standard, in consecutive patients with suspected or known CAD, and relevant data were extracted by 2 independent reviewers. Summary diagnostic accuracies were calculated, and the effect of covariates on the diagnostic performance was evaluated by meta-regression. RESULTS: Twenty-five studies were included. In per-patient analysis (n = 2303), pooled sensitivity was 99% [95% confidence interval (CI), 97%-99%] with specificity of 89% (95% CI, 84%-92%). The summary positive (+LR) and negative (-LR) likelihood ratios were 8.6 (95% CI, 6.4-11.6) and 0.02 (95% CI, 0.01-0.03), respectively. In per-segment analysis (n = 32,615), pooled sensitivity was 94% (95% CI, 92%-96%) with specificity of 97% (95% CI, 96%--98%). Summary +LR and -LR were 30.2 (95% CI, 22.1-43.5) and 0.06 (95% CI, 0.04-0.08), respectively. CONCLUSIONS: DSCT-CA seems to be robust to elevate heart rates while maintaining a high level of diagnostic performance.
Authors:
Ali Salavati; Farid Radmanesh; Kazem Heidari; Ben A Dwamena; Aine M Kelly; Paul Cronin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-20
Journal Detail:
Title:  Journal of cardiovascular computed tomography     Volume:  -     ISSN:  1876-861X     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2012-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308347     Medline TA:  J Cardiovasc Comput Tomogr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Nuclear Medicine, Center for PET/CT, Zentralklinik Bad Berka, Bad Berka 99437, Germany; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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