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European Heart Journal Advance Access published online on July 31, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl148
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received March 27, 2006
Revised June 20, 2006
Accepted June 23, 2006

Clinical research

Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease

Marc Dewey 1 *, Hans-Peter Dübel 2, Tania Schink 3, Gert Baumann 2, and Bernd Hamm 1

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

* To whom correspondence should be addressed.
Marc Dewey, E-mail: marc.dewey{at}charite.de


  Abstract

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 {chi}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.

Keywords: Coronary artery; Coronary angiography; Cardiac; Computed tomography; Electrocardiography; Exercise test; Diagnosis; Sensitivity.
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