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Non-Invasive Scan Accurate for Coronary Artery Disease

But not as accurate as conventional angiography

WEDNESDAY, Nov. 26 (HealthDay News) -- A non-invasive computed tomography (CT) scan with four times the strength of more widely available scanners is accurate in determining the presence and severity of coronary artery disease, but is not as accurate as conventional angiography, according to the results of a study published in the Nov. 27 issue of the New England Journal of Medicine.

Julie M. Miller, M.D., from Johns Hopkins University School of Medicine in Baltimore, and colleagues compared the accuracy of 64-row, 0.5-mm multidetector CT angiography and conventional coronary angiography in 291 patients (40 years or older, calcium scores of 600 or less) with suspected coronary artery disease.

The researchers found that 56 percent of patients had obstructive coronary artery disease, as defined by stenoses of 50 percent or more. CT angiography had an area under the receiver-operating-characteristic curve (AUC) of 0.93, a sensitivity of 85 percent, a specificity of 90 percent, a positive predictive value of 91 percent, and a negative predictive value of 83 percent, the report indicates. CT and conventional angiography were similar in their ability to identify patients who subsequently underwent revascularization (AUC 0.84 and 0.82, respectively). Two patients who underwent CT angiography had serious reactions to the contrast medium, the authors note.

"Multidetector CT angiography accurately identifies the presence and severity of obstructive coronary artery disease and subsequent revascularization in symptomatic patients," Miller and colleagues conclude. "The negative and positive predictive values indicate that multidetector CT angiography cannot replace conventional coronary angiography at present."

The study was partially funded by Toshiba Medical Systems. Several study authors have financial relationships with the pharmaceutical and medical equipment industry.

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