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European Heart Journal Advance Access originally published online on November 2, 2007
European Heart Journal 2007 28(24):3042-3050; doi:10.1093/eurheartj/ehm466
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis

Jawdat Abdulla1,*, Steen Z. Abildstrom2, Ole Gotzsche3, Erik Christensen4, Lars Kober5 and Christian Torp-Pedersen6

1 Division of Cardiology, Department of Medicine, Glostrup University Hospital, Copenhagen, Denmark
2 Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
3 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
4 Clinic of Internal Medicine I, Bispebjerg University Hospital, Copenhagen, Denmark
5 Rigshospitalet Heart Centre, Department of Medicine, Division of Cardiology, Copenhagen, Denmark
6 Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark

Received 20 March 2007; revised 12 September 2007; accepted 24 September 2007; online publish-ahead-of-print 2 November 2007.

* Corresponding author. Lyovej 18, 3.TV, DK-2000 Frederiksberg, Denmark. Fax: +45 39760107. E-mail address: ja{at}heart.dk

Aims: To evaluate the diagnostic accuracy of 64-slice multi-detector computed tomography coronary angiography (64-SCTA) compared with the standard reference conventional coronary angiography (CCA).

Methods and results: Based on a systematic search, 27 studies including 1740 patients were eligible for meta-analyses. Nineteen studies examined native coronary arteries (n = 1,251), four studies examined coronary artery by-pass grafts (CABG) (n = 271), and five studies examined coronary stents (n = 270). Overall 18 920 segments were assessable and 810 (4%) were unassessable. The prevalence of native coronary artery stenosis in per-segment (19 studies) and per-patients (13 studies) populations were 19 and 57.5% respectively. Accuracy tests with 95% confidence intervals comparing 64-SCTA vs. CCA showed that sensitivity, specificity, positive predictive and negative predictive values for native coronary arteries were 86(85–87), 96(95.5–96.5), 83, and 96.5% by per-segment analysis; 97.5(96–99), 91(87.5–94), 93, and 96.5% by per-patient analysis; 98.5(96–99.5), 96(93.5–97.5), 92 and 99% for CABGs; 80(70–88.5), 95(92–97), 80, and 95% for stent restenosis; and 87(86.5–88), 96(95.5–96.5), 83.5, and 97% by overall per-segment analysis.

Conclusion: The high diagnostic accuracy of 64-SCTA validates this non-invasive technique as a potential alternative to CCA in carefully selected populations suspected for coronary stenosis.

Key Words: Computed tomography • Angiography • Coronary artery • Coronary artery disease


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