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Coronary CTA yielded higher diagnostic ability than perfusion in ACCURACY substudy
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Coronary CTA demonstrated a high level of diagnostic accuracy compared with myocardial perfusion imaging when both were compared with invasive coronary angiography.
The researchers enrolled 43 patients from the ACCURACY trial who were scheduled for invasive angiography and who had no known previous CAD. All patients underwent myocardial perfusion imaging and coronary CTA within six weeks before invasive coronary angiography.
According to the study results, the sensitivity of CTA diagnosing ≥50% stenosis vs. invasive angiography was 80% (95% CI, 44.4%-97.5%); specificity was 93.8% (95% CI, 79.2%-99.2%); positive predictive value was 80% (95% CI, 44.4%-97.5%); and negative predictive value was 93.8% (95% CI, 79.2%-99.2%). For stenosis ≥70%, the sensitivity of CTA was 75% (95% CI, 19.4%-99.4%); specificity was 89.5% (95% CI, 75.2%-97.1%); positive predictive value was 42.9% (95% CI, 9.9%-81.6%); and negative predictive value was 97.1% (95% CI, 85.1%-99.9%).
The CTA diagnostic ability was higher than that demonstrated with myocardial perfusion imaging vs. invasive angiography for both ≥50% and ≥70% stenosis for sensitivity, specificity, positive predictive value and negative predictive value (P<.001 for all) in every category except for sensitivity in ≥70% stenosis.
“There was a high sensitivity, specificity, positive predictive value and negative predictive value of multidetector CT in detecting significant lesions found on invasive coronary angiography in patients presenting with chest pain and no known history of CAD,” Matthew J. Budoff, MD, an associate professor of medicine at the Harbor-Los Angeles Biomedical Research Institute at the University of California Los Angeles, told an audience in his presentation. “There was a high sensitivity and specificity of multidetector CT in diagnosing coronary lesions seen on invasive coronary angiography compared with myocardial perfusion imaging, and our results are comparable to previously published studies.” – by Eric Raible
Budoff MJ. #89. Presented at: Society of Cardiovascular Computed Tomography 4th Annual Scientific Meeting; July 16-19, 2009; Orlando, Fla.