Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study.

Abstract:

BACKGROUND:Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultrafast CT scanning and coronary angiography in a large number of symptomatic patients. METHODS AND RESULTS:The study population consisted of 710 patients from six participating centers. A multivariate logistic regression model was used to evaluate the individual contributions of age, number of calcified vessels, and the calcium score for the probability of angiographically significant disease. Of the 710 patients enrolled, 427 patients had significant angiographic disease, and coronary calcification was detected in 404, yielding a sensitivity of 95%. Of the 23 patients without calcifications, 19 (83%) had single-vessel disease at angiography. Of the 283 patients without angiographically significant disease, 124 had negative ultrafast CT coronary studies, for a specificity of 44%. An increasing number of vessels with calcification present on ultrafast CT was found to increase specificity for the presence of obstructive coronary artery disease in at least one vessel (P < .0001). As the log of the calcium score increases, the probability of multivessel obstructive disease increases (P < .0001). CONCLUSIONS:Ultrafast CT scanning is an noninvasive, non-exercise-dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.

journal_name

Circulation

journal_title

Circulation

authors

Budoff MJ,Georgiou D,Brody A,Agatston AS,Kennedy J,Wolfkiel C,Stanford W,Shields P,Lewis RJ,Janowitz WR,Rich S,Brundage BH

doi

10.1161/01.cir.93.5.898

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

898-904

issue

5

eissn

0009-7322

issn

1524-4539

journal_volume

93

pub_type

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