CT Coronary Angiography versus Coronary Angiography to Detect Specificity and Sensitivity of CT Coronary

Abstract

Background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive Computed Tomography (CT) coronary angiography are used in the diagnosis of Coronary Artery Disease (CAD). Objective: The present report aims to evaluate the specificity and sensitivity of CT coronary angiography in diagnosis of coronary artery disease compared to the standard invasive coronary angiography. Methods: A retrospective study was done over 2 years started from May of 2015 up to May of 2017. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography and those with CT coronary angiogram. Data on special indications (bypass grafts, in-stent-restenosis) were also included in the evaluation. The CT scanners used with 320 slices. The study included patients with diabetes, hypertension, and data included age, glomerular filtration rate and ejection fraction. Results: Of the 99 patients included in the study, sensitivity of the total lesions were 87.1% which was highest for the graft lesions (100% sensitivity) and lowest for the Left Main (LM) lesions (83.3% sensitivity), on the other hand the specificity of the total lesion were high (98.1% specificity) which also was highest for the graft lesions (100% specificity) and lowest for the Left Anterior Descending (LAD) lesions (95% specificity). Regarding accuracy, CT coronary was 96.6% accurate for the whole lesions. Conclusions: From a medical point of view, CT coronary angiography using scanners with at least 320 slices should be recommended as a test to rule in obstructive coronary stenosis in order to avoid inappropriate invasive coronary angiography in patients with an intermediate pretest probability of CAD. Multi detector CT (MDCT) has reasonably high accuracy for detecting significant obstructive CAD when assessed at artery level.