Document Detail


Reliable high-speed coronary computed tomography in symptomatic patients.
MedLine Citation:
PMID:  17707184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our objective was to prospectively evaluate the diagnostic performance of the high-speed dual-source computed tomography scanner (DSCT), with an increased temporal resolution (83 ms), for the detection of significant coronary lesions (> or =50% lumen diameter reduction) in a clinically wide range of patients. BACKGROUND: Cardiac motion artifacts may decrease coronary image quality with use of earlier computed tomography scanners that have a limited temporal resolution. METHODS: We prospectively studied 100 symptomatic patients (79 men, 21 women, mean age 61 +/- 11 years) with atypical (18%) or typical (55%) angina pectoris, or unstable coronary artery disease (27%) scheduled for conventional coronary angiography. Mean scan time was 8.58 +/- 1.52 s. Mean heart rate was 68 +/- 11 beats/min. Quantitative coronary angiography was used as the standard of reference. Irrespective of image quality or vessel size, all segments were included for analysis. RESULTS: Invasive coronary angiography demonstrated no significant disease in 23%, single-vessel disease in 31%, and multivessel disease in 46% of patients; 1,489 coronary segments, containing 220 significant (14.8%) stenoses, were available for analysis. Sensitivity, specificity, and positive and negative predictive values of DSCT coronary angiography for the detection of significant lesions on a segment-by-segment analysis were 95% (95% confidence interval [CI] 90 to 97), 95% (95% CI 93 to 96), 75% (95% CI 69 to 80), 99% (95% CI 98 to 99), respectively, and on a patient-based analysis 99% (95% CI 92 to 100), 87% (95% CI 65 to 97), 96% (95% CI 89 to 99), and 95% (95% CI 74 to 100), respectively. CONCLUSIONS: Noninvasive DSCT coronary angiography is highly sensitive to detect and to reliably rule out the presence of a significant coronary stenosis in patients presenting with atypical or typical angina pectoris, or unstable coronary artery disease.
Authors:
Annick C Weustink; Willem B Meijboom; Nico R Mollet; Masato Otsuka; Fransesca Pugliese; Carlos van Mieghem; Roberto Malago; Niels van Pelt; Marcel L Dijkshoorn; Filippo Cademartiri; Gabriel P Krestin; Pim J de Feyter
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-08-06
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  50     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-10-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786-94     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina Pectoris / radiography
Coronary Angiography / methods*
Coronary Artery Disease / radiography
Coronary Stenosis / radiography*
Female
Humans
Male
Middle Aged
Prospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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