The diagnostic accuracy of coronary computed tomography angiography in patients with and without previous coronary interventions |
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| Institution: | 1. Radiology Department, Al-Shifa Hospital, Gaza-Palestine, Palestine;2. Medical Imaging Department, Al-Azhar University, Gaza-Palestine, Palestine;1. Sunnybrook Health Sciences Centre, Canada;2. University of Toronto, Canada;1. Medical Imaging and Radiation Therapy, School of Medicine, UG Assert, Brookfield Health Sciences, University College Cork, T12 AK54 Ireland;2. Department of Radiology, Cork University Hospital, Wilton Road, Cork, T12 DFK4 Ireland;1. Radiography Department, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O Box KB 143, Korle-Bu Campus, Accra, Ghana.;2. Department of Nuclear Safety and Security, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Ghana, Legon.;3. Medical Physics Department, School of Nuclear and Allied Sciences, University of Ghana, Atomic Campus, Accra, Ghana.;4. Radiation Protection Institute (RPI), Ghana Atomic Energy Commission, Accra, Ghana.;5. Radiological and Non-ionizing Radiation Directorate, Nuclear Regulatory Authority, Accra, Ghana. |
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| Abstract: | BackgroundInvasive coronary angiography (ICA) is the gold standard for imaging coronary arteries and the severity of coronary artery disease (CAD). Coronary computed tomography angiography (CCTA) has undergone remarkable progress in the diagnosis of CAD.ObjectivesTo evaluate the effect of prior vs no previous coronary interventions on the diagnostic accuracy of CCTA as an alternative to ICA to improve health outcomes for patients with suspected CAD.MethodsA prospective cohort study was carried out among patients suspected of CAD and for evaluation of grafts and stents to investigate recurrent ischemic symptoms. 120 patients imaged by CCTA were then referred to ICA, which is considered the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CCTA were assessed relative to ICA.ResultsBased on a per-patient analysis, the comparison with ICA reveals variations in sensitivity, specificity, PPV, NPV and accuracy of CCTA. In patients without any previous coronary interventions, the sensitivity was 97.8%, and specificity was 95.6%. The PPV and NPV were 97.8% and 95.5%, respectively. Regarding patients with coronary artery bypass grafts (CABG), the sensitivity was 95% and specificity 100%. The PPV and NPV were 100% and 90.9%, respectively. Regarding patients with prior percutaneous coronary intervention (PCI), the results were a sensitivity of 84.6%, specificity of 77.8%, PPV of 84.6% and NPV of 77.8%.ConclusionCCTA is a powerful diagnostic tool, especially for the evaluation of the major coronary arteries and evaluation of patients with prior CABG. ICA is recommended for evaluation of patients with an intracoronary stent. |
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