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Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease
Marc Dewey1,*, Hans-Peter Dübel2, Tania Schink3, Gert Baumann2 and Bernd Hamm1
1 Department of Radiology, Medical School, Humboldt-Universit鋞 zu Berlin, Germany
2 Department of Cardiology, Medical School, Humboldt-Universit鋞 zu Berlin, Germany
3 Medical Biometry Charité, Medical School, Humboldt-Universit鋞 zu Berlin, Germany
Aims: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.
Methods and results: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the 2 test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78–97%) and 83% (30 of 36 patients, 95%CI 67–94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57–85%) and 31% (11 of 36 patients, 95%CI 16–48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3–16%) vs. 19% (15 of 80 patients, 95%CI 11–29%)].
Conclusion: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.
Key Words: Coronary artery - Coronary angiography - Cardiac - Computed tomography - Electrocardiography - Exercise test - Diagnosis - Sensitivity |
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发表于 2007-11-5 14:57:38