16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome: A blinded prospective study

Eduard Ghersin, Diana Litmanovich, Robert Dragu, Shmuel Rispler, Jonathan Lessick, Amos Ofer, Olga R. Brook, Luis Gruberg, Rafael Beyar, Ahuva Engel

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS. Sixty-six consecutive patients (52 men and 14 women; average age, 57 ± 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 ± 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS. CT coronary angiography was technically successful in 59 patients (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION. CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.

Original languageEnglish (US)
Pages (from-to)177-184
Number of pages8
JournalAmerican Journal of Roentgenology
Volume186
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

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Acute Chest Syndrome
Acute Pain
Coronary Angiography
Chest Pain
Prospective Studies
Coronary Artery Disease
Heart Rate
Sensitivity and Specificity
Computed Tomography Angiography

Keywords

  • Angiography
  • Chest pain
  • Coronary artery disease
  • MDCT angiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome : A blinded prospective study. / Ghersin, Eduard; Litmanovich, Diana; Dragu, Robert; Rispler, Shmuel; Lessick, Jonathan; Ofer, Amos; Brook, Olga R.; Gruberg, Luis; Beyar, Rafael; Engel, Ahuva.

In: American Journal of Roentgenology, Vol. 186, No. 1, 01.2006, p. 177-184.

Research output: Contribution to journalArticle

Ghersin, E, Litmanovich, D, Dragu, R, Rispler, S, Lessick, J, Ofer, A, Brook, OR, Gruberg, L, Beyar, R & Engel, A 2006, '16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome: A blinded prospective study', American Journal of Roentgenology, vol. 186, no. 1, pp. 177-184. https://doi.org/10.2214/AJR.04.1232
Ghersin, Eduard ; Litmanovich, Diana ; Dragu, Robert ; Rispler, Shmuel ; Lessick, Jonathan ; Ofer, Amos ; Brook, Olga R. ; Gruberg, Luis ; Beyar, Rafael ; Engel, Ahuva. / 16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome : A blinded prospective study. In: American Journal of Roentgenology. 2006 ; Vol. 186, No. 1. pp. 177-184.
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abstract = "OBJECTIVE. The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS. Sixty-six consecutive patients (52 men and 14 women; average age, 57 ± 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 ± 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50{\%} or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS. CT coronary angiography was technically successful in 59 patients (89{\%}). After exclusion of 20 (3.1{\%}) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80{\%} (68/85), 89{\%} (482/544), 52{\%} (68/130), 97{\%} (482/499), and 87{\%} (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93{\%}, 88{\%}, 86{\%}, and 86{\%}, respectively. CONCLUSION. CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.",
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T2 - A blinded prospective study

AU - Ghersin, Eduard

AU - Litmanovich, Diana

AU - Dragu, Robert

AU - Rispler, Shmuel

AU - Lessick, Jonathan

AU - Ofer, Amos

AU - Brook, Olga R.

AU - Gruberg, Luis

AU - Beyar, Rafael

AU - Engel, Ahuva

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N2 - OBJECTIVE. The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS. Sixty-six consecutive patients (52 men and 14 women; average age, 57 ± 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 ± 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS. CT coronary angiography was technically successful in 59 patients (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION. CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.

AB - OBJECTIVE. The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS. Sixty-six consecutive patients (52 men and 14 women; average age, 57 ± 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 ± 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS. CT coronary angiography was technically successful in 59 patients (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION. CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.

KW - Angiography

KW - Chest pain

KW - Coronary artery disease

KW - MDCT angiography

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