European Heart Journal Advance Access originally published online on July 31, 2006
European Heart Journal 2007 28(20):2485-2490; doi:10.1093/eurheartj/ehl148
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Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease
1 Department of Radiology, Medical School, Humboldt-Universität zu Berlin, Germany
2 Department of Cardiology, Medical School, Humboldt-Universität zu Berlin, Germany
3 Medical Biometry Charité, Medical School, Humboldt-Universität zu Berlin, Germany
Received 27 March 2006; revised 20 June 2006; accepted 23 June 2006; online publish-ahead-of-print 31 July 2006.
* Corresponding author. Tel: +49 30 4505 27296; fax: +49 30 4505 27996. E-mail address: marc.dewey{at}charite.de
Aims: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.
Methods and results: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the 
2 test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78–97%) and 83% (30 of 36 patients, 95%CI 67–94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57–85%) and 31% (11 of 36 patients, 95%CI 16–48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3–16%) vs. 19% (15 of 80 patients, 95%CI 11–29%)].
Conclusion: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.
Key Words: Coronary artery • Coronary angiography • Cardiac • Computed tomography • Electrocardiography • Exercise test • Diagnosis • Sensitivity
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