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Many single center studies have reported high diagnostic accuracy of computed tomography coronary angiography (CTCA) for the detection of obstructive coronary artery disease (CAD), but multi-center studies have yielded variable results. We perform a meta-analysis of multi-center studies evaluating the diagnostic accuracy of 64-slice CTCA compared to invasive coronary angiography for the diagnostic of CAD.
The Medline, Cochrane library and Biomed Central databases were searched for relevant original articles. Criteria for article inclusion were: (a) multi-center studies (b) use of 64-slice CTCA as diagnostic test for obstructive CAD, and (c) use of invasive coronary angiography as the reference standard. After data extraction, the analysis was performed on a per-patient basis, according to a random-effects model.
The analysis pooled the results from 6 studies including 1859 patients and provided the following diagnostic accuracy on a per-patient basis: sensitivity 91.4% (95% Confidence interval (Cl) 89.5%- 93.1%); specificity 69.3 % (95% Cl: 66.1%-72.4%); positive predictive value 77.3 % (95% Cl: 74.8%-79.7%); negative predictive value 87.6% (95% Cl: 84.9%-90.0%); positive likelihood ratio 5.05 (95% Cl 2.70-9.44); negative likelihood ratio 0.12 (95% Cl 0.07-0.19); diagnostic odd ratio 57.66 (95% Cl 19.51-170.47).
The diagnostic performance of this meta-analysis of multi-center studies, which reflect real-world clinical practice, is not as good as what has been previously reported in single center studies.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: CT/Multimodality IV
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1182-350
- 2013 American College of Cardiology Foundation