Clinical experience regarding the diagnostic value of segment-by-segment coronary computed tomography angiography in comparison with that of invasive coronary angiography

Experiência clínica na avaliação segmento por segmento demonstrando o valor diagnóstico da angiotomografia das artérias coronárias em comparação com o cateterismo em uma análise de 844 segmentos

Abstract

Objective:

To compare the degree of coronary stenosis (≥ 50% luminal narrowing) determined by coronary computed tomography angiography (CCTA) with that determined by invasive coronary angiography (ICA), using segment-by-segment analysis.

Materials and Methods:

This was a retrospective study of the records of patients who underwent CCTA and ICA between January 2014 and June 2018 at a general hospital in Brazil. Receiver operating characteristic curve analysis was applied, and the areas under the curve were used in order to assess the overall accuracy of the methods.

Results:

The degree of coronary stenosis was evaluated in a total of 844 arterial segments. The diagnostic performance of CCTA was good, with a sensitivity of 82.3%, a specificity of 96.4%, and a negative predictive value of 97.7% (95% CI: 96.5-98.5). In the segment-by-segment analysis, CCTA had excellent accuracy for the left main coronary artery and for other segments.

Conclusion:

In clinical practice at general hospitals, CCTA appears to have diagnostic performance comparable to that of ICA.

Keywords:
Multidetector computed tomography; Coronary angiography/methods; Coronary artery disease/diagnostic imaging