Precisión de la tomografía de 64 cortes en el diagnóstico de la cardiopatía isquémica / Accuracy of 64 slice computed tomography angiography in the diagnosis of ischemic coronary artery disease

ABSTRACT

INTRODUCTION AND OBJECTIVES: Multislice computed tomography coronary angiography (MSCT-CA) has been developed in the last years. One of the advantages is to supply information of the lumen and wall of the vessels. The aim was to assess the diagnostic accuracy of MSCT - CA to detect significant coronary stenoses taking as gold standard the invasive coronary angiography (ICA). PATIENTS AND METHODS: We studied, after informed consent, 64 consecutive patients (50 males). First MSCT - CA was performed and afterwards with a media of 45 days the ICA. Sensitivity (SENS), specificity (ESP), positive predictive value (PPV), negative predictive value (NPV) and predictive precision (PP) were assessed per patients, per arteries and per segments. RESULTS: The SENS, ESP, PPV, PNV and PP were 96.4, 91.2, 87, 96.8, 93.5% respectively per patients and 95.7, 97, 88.2, 98.9, 96.7% respectively per arteries and 91, 99, 89, 99.6, 98.7% respectively per segments. The diagnostic accuracy decreased in patients with heart rate higher than 65 beats per minute, as well as in patients with calcium scoring higher than 400 Agatston Units or body mass index with or higher than 30 kg/m2 CS. CONCLUSIONS: Our results suggest that MSCT - CA has a good accuracy, especially in the ESP and NPV for the diagnosis of significant coronary stenoses in selected patients with calcium scoring of 400 Agatston Units or lower, heart rate with 65 beats per minute or lower with regular rhythm and body mass index lower than 30 kg/m2 CS.