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Adjunctive value of CT coronary angiography in the diagnostic work-up of patients with typical angina pectoris.
Eur Heart J. 2007 Aug; 28(15):1872-8.EH

Abstract

AIMS

To determine the adjunctive value of CT coronary angiography (CTCA) in the diagnostic work-up of patients with typical angina pectoris.

METHODS AND RESULTS

CTCA was performed in 62 consecutive patients (45 male, mean age 58.8 +/- 7.7 years) with typical angina undergoing diagnostic work-up including exercise-ECG and conventional coronary angiography. Only patients with sinus heart rhythm and ability to breath hold for 20 s were included. Patients with initial heart rates >/=70 beats/min received beta-blockers. We determined the post-test likelihood ratios, to detect or exclude patients with significant (>/=50% lumen diameter reduction) stenoses, of exercise-ECG and CTCA separately, and of CT performed after exercise-ECG testing. The prevalence of patients with significant coronary artery disease (CAD) was 74%. Positive and negative likelihood ratios for exercise-ECG were 2.3 [95% confidence interval (CI): 1.0-5.3] and 0.3 (95% CI: 0.2-0.7) and for CTCA 7.5 (95% CI: 2.1-27.1) and 0.0 (95% CI: 0.0-8), respectively. CTCA increased the post-test probability of significant CAD after a negative exercise-ECG from 58 to 91%, and after a positive exercise-ECG from 89 to 99%, while CT correctly identified patients without CAD (probability 0%).

CONCLUSION

Non-invasive CTCA is a potentially useful tool, in the diagnostic work-up of patients with typical angina pectoris, both to detect and to exclude significant CAD.

Authors+Show Affiliations

Erasmus Medical Center, Department of Cardiology, Room Ca-228a, Dr Molewaterplein 40, Rotterdam 3000CA, The Netherlands. n.mollet@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17350972

Citation

Mollet, Nico R., et al. "Adjunctive Value of CT Coronary Angiography in the Diagnostic Work-up of Patients With Typical Angina Pectoris." European Heart Journal, vol. 28, no. 15, 2007, pp. 1872-8.
Mollet NR, Cademartiri F, Van Mieghem C, et al. Adjunctive value of CT coronary angiography in the diagnostic work-up of patients with typical angina pectoris. Eur Heart J. 2007;28(15):1872-8.
Mollet, N. R., Cademartiri, F., Van Mieghem, C., Meijboom, B., Pugliese, F., Runza, G., Baks, T., Dikkeboer, J., McFadden, E. P., Freericks, M. P., Kerker, J. P., Zoet, S. K., Boersma, E., Krestin, G. P., & de Feyter, P. J. (2007). Adjunctive value of CT coronary angiography in the diagnostic work-up of patients with typical angina pectoris. European Heart Journal, 28(15), 1872-8.
Mollet NR, et al. Adjunctive Value of CT Coronary Angiography in the Diagnostic Work-up of Patients With Typical Angina Pectoris. Eur Heart J. 2007;28(15):1872-8. PubMed PMID: 17350972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adjunctive value of CT coronary angiography in the diagnostic work-up of patients with typical angina pectoris. AU - Mollet,Nico R, AU - Cademartiri,Filippo, AU - Van Mieghem,Carlos, AU - Meijboom,Bob, AU - Pugliese,Francesca, AU - Runza,Giuseppe, AU - Baks,Timo, AU - Dikkeboer,Jolmer, AU - McFadden,Eugene P, AU - Freericks,Michel P, AU - Kerker,Jacques P, AU - Zoet,Stieneke K, AU - Boersma,Eric, AU - Krestin,Gabriel P, AU - de Feyter,Pim J, Y1 - 2007/03/09/ PY - 2007/3/14/pubmed PY - 2008/1/9/medline PY - 2007/3/14/entrez SP - 1872 EP - 8 JF - European heart journal JO - Eur Heart J VL - 28 IS - 15 N2 - AIMS: To determine the adjunctive value of CT coronary angiography (CTCA) in the diagnostic work-up of patients with typical angina pectoris. METHODS AND RESULTS: CTCA was performed in 62 consecutive patients (45 male, mean age 58.8 +/- 7.7 years) with typical angina undergoing diagnostic work-up including exercise-ECG and conventional coronary angiography. Only patients with sinus heart rhythm and ability to breath hold for 20 s were included. Patients with initial heart rates >/=70 beats/min received beta-blockers. We determined the post-test likelihood ratios, to detect or exclude patients with significant (>/=50% lumen diameter reduction) stenoses, of exercise-ECG and CTCA separately, and of CT performed after exercise-ECG testing. The prevalence of patients with significant coronary artery disease (CAD) was 74%. Positive and negative likelihood ratios for exercise-ECG were 2.3 [95% confidence interval (CI): 1.0-5.3] and 0.3 (95% CI: 0.2-0.7) and for CTCA 7.5 (95% CI: 2.1-27.1) and 0.0 (95% CI: 0.0-8), respectively. CTCA increased the post-test probability of significant CAD after a negative exercise-ECG from 58 to 91%, and after a positive exercise-ECG from 89 to 99%, while CT correctly identified patients without CAD (probability 0%). CONCLUSION: Non-invasive CTCA is a potentially useful tool, in the diagnostic work-up of patients with typical angina pectoris, both to detect and to exclude significant CAD. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/17350972/Adjunctive_value_of_CT_coronary_angiography_in_the_diagnostic_work_up_of_patients_with_typical_angina_pectoris_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehl563 DB - PRIME DP - Unbound Medicine ER -