@article{02b912cd5c7d45aaaa2cc1936c2b07db,
title = "Accuracy of multidetector computed tomography for detection of coronary artery stenosis in acute coronary syndrome compared with stable coronary disease: A CORE64 multicenter trial substudy",
abstract = "Background: Multi-detector computed tomography angiography (MDCTA) is a promising method for risk assessment of patients with acute chest pain. However, its diagnostic performance in higher-risk patients has not been investigated in a large international multicenter trial. Therefore, in the present study we sought to estimate the diagnostic accuracy of MDCTA to detect significant coronary stenosis in patients with acute coronary syndrome (ACS).Methods Patients included in the CORE64 study were categorized as suspected-ACS or non-ACS based on clinical data. A 64-row coronary MDCTA was performed before invasive coronary angiography (ICA) and both exams were evaluated by blinded, independent core laboratories.Results From 371 patients included, 94 were categorized as suspected ACS and 277 as non-ACS. Patient-based analysis showed an area under the receiver-operating-characteristic curve (AUC) for detecting ≥ 50% coronary stenosis of 0.95 (95% CI: 0.88-0.98) in ACS and 0.92 (95% CI: 0.88-0.95) in non-ACS group (P = 0.29). The sensitivity, specificity, positive and negative predictive values of MDCTA were 0.90(0.80-0.96), 0.88(0.70-0.98), 0.95(0.87-0.99) and 0.77(0.58-0.90) in suspected ACS patients and 0.87(0.81-0.92), 0.86(0.79-0.92), 0.91(0.85-0.95) and 0.82(0.74-0.89) in non-ACS patients (P NS for all comparisons). The mean calcium scores (CS) were 282 ± 449 in suspected ACS and 435 ± 668 in non-ACS group. The accuracy of CS to detect significant coronary stenosis was only moderate and the absence or minimal coronary artery calcification could not exclude the presence of significant coronary stenosis, particularly in ACS patients.Conclusions The diagnostic accuracy of MDCTA to detect significant coronary stenosis is high and comparable for both ACS and non-ACS patients.",
keywords = "Acute coronary syndrome, Angiography, Multi-detector computed tomography angiography, Tomography",
author = "Leonardo Sara and Rochitte, {Carlos E.} and Lemos, {Pedro A.} and Hiroyuki Niinuma and Marc Dewey and Shapiro, {Edward P.} and Ilan Gottlieb and Mansur, {Ant{\^o}nio P.} and Nicolau, {Jos{\'e} C.} and Lardo, {Albert C.} and Azevedo, {Clerio F.} and Roberto Kalil-Filho and Vavere, {Andrea L.} and Silvia Cohn and Christopher Cox and Jeffrey Brinker and Miller, {Julie M.} and Lima, {Jo{\~a}o A.C.}",
note = "Funding Information: Significant: Research Grants: Heisenberg Program of the German Research Foundation (DFG) for a Professorship (DE 1361/14-1), FP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), European Regional Development Fund (20072013 2/05, 20072013 2/48), German Heart Foundation/German Foundation of Heart Research (F/23/08, F/27/10), Joint program of the DFG and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110), GE Healthcare, Bracco, Guerbet, and Toshiba Medical Systems. Funding Information: This work was supported by grants from Toshiba Medical Systems Corporation ; the Doris Duke Charitable Foundation ; the National Heart, Lung, and Blood Institute [ RO1-HL66075-01 and HO1-HC95162-01 ]; the National Institute on Aging [ RO1-AG021570-01 ]; and the Donald W. Reynolds Foundation . Funding Information: Drs. Miller, Dewey, Shapiro, Lardo and Lima report receiving a grant support from the Toshiba Medical Systems Corporation ; Drs. Dewey, Lardo and Lima, speakers' fees from the Toshiba Medical Systems Corporation ; Dr. Dewey, speaker's fees from the Bayer and Schering and grant support from the GE Healthcare and Bracco ; Dr. Lardo reports receiving a grant support from the CT Core Laboratory and Dr. Lima, a grant support from the GE Medical Systems . There is no other potential conflict of interest relevant to this article. Publisher Copyright: {\textcopyright} 2014 Elsevier Ireland Ltd. All rights reserved.",
year = "2014",
month = dec,
day = "15",
doi = "10.1016/j.ijcard.2014.08.130",
language = "English (US)",
volume = "177",
pages = "385--391",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "2",
}