Objective: To evaluate the diagnostic accuracy of 64-slice computed tomography (CT) coronary angiography (CA) for the detection of significant coronary artery stenosis (≥50% lumen reduction) as compared to invasive coronary angiography (ICA) in a population of patients with chest pain and high risk. Materials andmethods: 44 patients (30 male;mean age 60.2±12.1yrs) with chest pain were prospectively enrolled. In patients with heart rate ≥70 bpm an oral dose of 100 mg of β -blocker was administered. For CT-CA (Sensation 64, Siemens, Germany) an intravenous bolus of 100 ml of iodinated contrast material (Iomeron 400, Bracco, Italy) was injected. The average scan time was 13.3±0.9s. Two observers evaluated CT-CA vs. ICA as a reference standard for the detection of significant (≥50% lumen reduction) coronary artery stenosis. Results: ICA demonstrated the absence of coronary artery disease (CAD) in 13.6% of the patients (6/44), the presence of non significant CAD 4.6% (2/44), single vessel disease in 27.2% (12/44) and multi-vessel disease in 54.6% (24/44) of the patients. None of the patients was excluded from the study population. Ninety-three significant obstructive coronary lesions were observed. Sensitivity, specificity, positive and negative predictive value of CTCA were 98.6% (70/71), 92.4% (97/105), 89.7% (70/78) and 99% (97/98), respectively.All patients with at least one significant coronary lesion were correctly identified by CT-CA. Conclusions: CT-CA is a reliable alternative to ICA in a selected population of patients with chest pain and high risk. (www.actabiomedica.it).

Coronary artery disease, Diagnostic accuracy, High risk, Invasive coronary angiography, Multislice computed tomography
Acta Biomedica
Department of Cardiology

Maffei, E, Palumbo, A, Martini, C, Ugo, F, Lina, D, Aldrovandi, A, … Cademartiri, F. (2010). Diagnostic accuracy of computedtomography coronary angiography in a high risk symptomatic population. Acta Biomedica, 81(1), 47–53. Retrieved from http://hdl.handle.net/1765/90136