Computed tomography coronary angiography vs. stress ECG in patients with stable angina

Ludovico La Grutta, Massimo Midiri, Palumbo, Ludovico La Grutta, Weustink, Erica Maffei, Aldrovandi, Sara Seitun, Chiara Martini, Belgrano, Francesco Coppolino, Nico R. Mollet, Cova, Filippo Cademartiri, Malagò

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Abstract

PURPOSE: This study compared the role of multislice computed tomography coronary angiography (MSCT-CA) and stress electrocardiography (ECG) in the diagnostic workup of patients with chronic chest pain. MATERIALS AND METHODS: MSCT-CA was performed in 43 patients (31 men, 12 women, mean age 58.8+/-7.7 years) with stable angina after a routine diagnostic workup involving stress ECG and conventional CA. The following inclusion criteria were adopted: sinus rhythm and ability to hold breath for 12 s. Beta-blockers were administered in patients with heart rate>or=70 beats/minute. In order to identify or exclude patients with significant stenoses (>or=50% lumen), we determined posttest likelihood ratios of stress test and MSCT-CA separately and of MSCT-CA performed after the stress test. RESULTS: The pretest probability of significant coronary artery disease (CAD) was 74%. Positive and negative likelihood ratios were 2.3 [95% confidence interval (CI) 1.0-5.3] and 0.3 (95% CI: 0.2-0.7) for the stress test and 10.0 (95% CI: 1.8-78.4) and 0.0 (95% CI: 0.0-infinity) for MSCT-CA, respectively. MSCT-CA increased the posttest probability of significant CAD after a negative stress test from 50% to 86% and after a positive stress test from 88% to 100%. MSCT-CA correctly detected all patients without CAD. CONCLUSIONS: Noninvasive MSCT-CA is a potentially useful tool in the diagnostic workup of patients with stable angina owing to its capability to detect or exclude significant CAD.
Original languageEnglish
Number of pages0
JournalLA RADIOLOGIA MEDICA
Volume2009-06
Publication statusPublished - 2009

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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    La Grutta, L., Midiri, M., Palumbo, La Grutta, L., Weustink, Maffei, E., Aldrovandi, Seitun, S., Martini, C., Belgrano, Coppolino, F., Mollet, N. R., Cova, Cademartiri, F., & Malagò (2009). Computed tomography coronary angiography vs. stress ECG in patients with stable angina. LA RADIOLOGIA MEDICA, 2009-06.