Author + information
- Received March 13, 2006
- Revision received May 2, 2006
- Accepted May 31, 2006
- Published online December 19, 2006.
- Joanne D. Schuijf, MSc⁎,†,‡,
- William Wijns, MD, PhD§,
- J. Wouter Jukema, MD, PhD⁎,‡,
- Douwe E. Atsma, MD, PhD⁎,
- Albert de Roos, MD, PhD†,
- Hildo J. Lamb, MD, PhD†,
- Marcel P.M. Stokkel, MD, PhD∥,
- Petra Dibbets-Schneider, MSc∥,
- Isabel Decramer, MSc§,¶,
- Pieter De Bondt, MD, PhD#,
- Ernst E. van der Wall, MD, PhD⁎,‡,
- Piet K. Vanhoenacker, MD¶ and
- Jeroen J. Bax, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
Objectives The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography.
Background Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown.
Methods A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. The MSCT studies were classified as having no CAD, nonobstructive (<50% luminal narrowing) CAD, or obstructive CAD. Myocardial perfusion imaging examinations were classified as showing normal or abnormal (reversible and/or fixed defects). In a subset of 58 patients, invasive coronary angiography was performed.
Results On the basis of the MSCT data, 41 patients (36%) were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients (29%) showed non-obstructive CAD, whereas at least 1 significant (≥50% luminal narrowing) lesion was observed in the remaining 40 patients (35%). Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%).
Conclusions Myocardial perfusion imaging and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. As compared to invasive angiography, MSCT has a high accuracy for detecting CAD in patients with an intermediate likelihood of CAD.
This work was financially supported by the Netherlands Heart Foundation, the Hague, the Netherlands (grant 2002B105).
- Received March 13, 2006.
- Revision received May 2, 2006.
- Accepted May 31, 2006.
- American College of Cardiology Foundation