Diagnostic performance of 128-slice computed tomography angiography in patients with suspected coronary artery disease

Objectives: To determine the diagnostic performance and influencing factors of 128-slice coronary computed to-mography angiography (CCTA) compared with invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD).Methods: A cross-sectional analysis study enrolled 139 patients suspected of having CAD, who underwent and received a 128-slice CCTA and ICA.Results: The patient-based model showed high sensitivity and a positive predictive value of 93.2% and 95.3%, respectively (for stenosis >= 50%). However, these values were lower when analyzed using vessel-based (85.6% and 81.1%) and segment=based (73.9% and 66.6%) models. Specificity and negative predictive value were highest in the segment-based model, decreasing in vessel-and patient-based models at 96.4% and 95.4%, 90.5% and 90.0%, and 36.4% and 42.1%, respectively (for stenosis >= 70%). All diagnostic values were reduced when the calcium score was >= 400 Agatston units.Conclusion: 128-slice CCTA is an optimal, minimally invasive, and high-performance method to diagnose the stenosis and morphology of coronary artery lesions. The diagnostic performance of 128-slice CCTA is very high. Heart rate and body mass index do not affect diagnostic accuracy, whereas a calcium score >= 400 Agatston units is a factor that causes a decrease in diagnostic performance.

Automated summary

This study demonstrates that 128-slice CCTA has high sensitivity and positive predictive value for diagnosing coronary artery disease, particularly in the patient-based model. However, these values are lower in the vessel-based and segment-based models. An increase in the calcium score decreases the diagnostic performance.