1. Diagnostic accuracy of Visipaque enhanced coronary computed tomographic angiography: a prospective multicenter trial
- Author
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Rine Nakanishi, Matthew J. Budoff, Joseph L. Thomas, Nove Kalia, Negin Nezarat, and Jason H. Cole
- Subjects
Adult ,Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Clinical Sciences ,Contrast Media ,Diagnostic accuracy ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Chest pain ,Coronary Angiography ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Multicenter trial ,Triiodobenzoic Acids ,Multidetector Computed Tomography ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Computed tomography angiography ,medicine.diagnostic_test ,business.industry ,Coronary Stenosis ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,Coronary Vessels ,United States ,Stenosis ,quantitative cardiac catheterization ,Cardiovascular System & Hematology ,Predictive value of tests ,Female ,diagnostic accuracy ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Author(s): Budoff, Matthew J; Kalia, Nove; Cole, Jason; Nakanishi, Rine; Nezarat, Negin; Thomas, Joseph L | Abstract: BackgroundAlthough several studies have shown promise for noninvasive angiography by coronary computed tomographic angiography (CCTA), few prospective multicenter trials have been conducted. This study evaluated the diagnostic accuracy of Visipaque enhanced CCTA to detect obstructive coronary stenosis compared with quantitative coronary angiography (QCA).Patients and methodsThree sites prospectively enrolled 77 patients (58.1% men, 54 years) with chest pain referred for invasive coronary angiography (ICA). Patients underwent CCTA (Lightspeed VCT/Visipaque 320) before ICA. CCTAs were graded on a 15-segment American Heart Association model by a CCTA core lab with blinded readers for the presence of obstructive stenosis (g50% or g70%); ICAs were independently graded for %stenosis by QCA, considered the reference standard. The efficacy of CCTA was assessed including all vessel segments for per-patient and per-vessel analyses.ResultsA total of 46 more than 50% stenoses in 27 (35%) patients, and 31 more than 70% stenoses in 20 (26%) patients, were identified by QCA. Per-patient and per-vessel efficacy of CCTA compared with QCA yielded sensitivities of 85% and specificities of 90 and 95%, respectively.ConclusionThis study shows the high accuracy of CCTA to reliably detect more than 50% and more than 70% stenoses in low-probability to intermediate-probability chest pain patients being referred for ICA. The high negative predictive values observed (92-100%) indicate that CCTA is also an effective noninvasive alternative to exclude obstructive coronary stenosis.
- Published
- 2017