Diagnostic Accuracy of 64-slice Dual-source Computed Tomography in the Detection of Coronary Artery Stenosis based on Patient Heart Rate and Calcium Scores

Abstract

Purpose: To assess the diagnostic accuracy of dual-source computed tomography (DSCT) in the detection of coronary artery stenosis (CAS) based on patient heart rate and calcium scores. Materials and Methods: This study included 102 patients (46 male, 56 female; mean age 64.1 ± 10.6 years; age range 37-92 years) with chest pain and who underwent DSCT as well as invasive coronary angiography. Patients were classified into three groups according to mean heart rate (<70 bpm, 70-90 bpm, and >90 bpm) and also classified in three groups according to Agatston calcium scores (<100, 100-400, and >400). Results: For patients with a mean heart rate < 70 bpm, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 98.5%, 98.2%, 93.6%, 99.1%, and 97.9%, respectively, 99.2%, 99.2%, 97.4%, 99.5%, and 99%, respectively, for 70-90 bpm; and 91.7%, 97.9%, 88.5%, 96.7%, and 95.7%, respectively, for >90 bpm. For calcium scores <100, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 97.2%, 99.0%, 97.0%, 99.3%, and 98.6%, respectively, 98.5%, 99.5%, 96.2%, 99.4%, and 99.0%, respectively, for calcium scores 100-400, and 95.8%, 97.0%, 87.4%, 97.2%, and 95.6%, respectively, for calcium scores >400. Conclusion: DSCT showed a high diagnostic accuracy and negative predictive value, regardless of heart rate and calcium score.