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64-Slice computed tomography angiography in the diagnosis and assessment of coronary artery disease : systematic review and meta-analysis
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Mowatt, G., Cook, J. A., Hillis, G. S., Walker, S. G. (Stephen G.), Fraser, C., Jia, X. and Waugh, Norman (2008) 64-Slice computed tomography angiography in the diagnosis and assessment of coronary artery disease : systematic review and meta-analysis. Heart, Vol.94 (No.11). pp. 1386-1393. doi:10.1136/hrt.2008.145292 ISSN 1355-6037.
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Official URL: http://dx.doi.org/10.1136/hrt.2008.145292
Abstract
Context: Coronary artery disease (CAD) is a major cause of mortality and ill health.
Objective: To assess whether 64-slice CT angiography might replace some coronary angiography (CA) for diagnosis and assessment of CAD.
Data sources: Electronic databases, conference proceedings and reference lists of included studies.
Study selection: Eligible studies compared 64-slice CT with a reference standard of CA in adults with suspected/known CAD, reporting sensitivity and specificity or true and false positives and negatives.
Data extraction: Two reviewers independently extracted data from included studies.
Results: Forty studies were included; 28 provided sufficient data for inclusion in the meta-analyses, all using a cut off point of ⩾50% stenosis to define significant CAD. In patient-based detection (n = 1286) 64-slice CT pooled sensitivity was 99% (95% credible interval (CrI) 97% to 99%), specificity 89% (95% CrI 83% to 94%), median positive predictive value (PPV) across studies 93% (range 64–100%) and negative predictive value (NPV) 100% (range 86–100%). In segment-based detection (n = 14 199) 64-slice CT pooled sensitivity was 90% (95% CrI 85% to 94%), specificity 97% (95% CrI 95% to 98%), median PPV across studies 76% (range 44–93%) and NPV 99% (range 95–100%).
Conclusions: 64-Slice CT is highly sensitive for patient-based detection of CAD and has high NPV. An ability to rule out significant CAD means that it may have a role in the assessment of chest pain, particularly when the diagnosis remains uncertain despite clinical evaluation and simple non-invasive testing.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Heart | ||||
Publisher: | B M J Group | ||||
ISSN: | 1355-6037 | ||||
Official Date: | 2008 | ||||
Dates: |
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Volume: | Vol.94 | ||||
Number: | No.11 | ||||
Page Range: | pp. 1386-1393 | ||||
DOI: | 10.1136/hrt.2008.145292 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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