Resumen

Background: The leading cause of morbidity in the West is coronary arterial disease (CAD), for which coronary angiography is the most important diagnostic test. Coronary angiotomography has been recently introduced as a noninvasive method of studying coronary arteries, and this study sought to assess the diagnostic accuracy of this technique in the diagnosis of CAD. Material and methods: A cross-sectional, diagnostic-test assessment study was conducted to compare coronary angiotomography to invasive angiography in patients without previous coronary disease. All patients underwent both tests consecutively on a blind basis. Coronary arteries were studied in accordance with the American Heart Association’s modified reference model of segment-based coronary analysis. Tomography validity indices (sensitivity, specificity, positive predictive value/PPV, negative predictive value/NPV, and global value) were calculated overall, with a breakdown by artery, patient and segment. Results: The study covered a total of 121 patients, comprising 47 women (38.8%) and 74 men (61.2%). Prevalence of coronary arterial disease was 38%, and hypertension was the most frequent risk factor. Overall evaluation by patient yielded a sensitivity and NPV of 100%, a specificity of 92% (95% CI: 86.0-99.0) and a global value of 94% (95% CI: 89.0-99.0). In terms of arteries, the highest validity was registered for the anterior descending artery, with a specificity of 98% (CI95%: 90.0-96.0) and an NPV of 97% (95%CI: 96.0-100). Lastly, the segment that displayed the highest validity was the distal right coronary artery, with a specificity and PPV of 100%. Conclusion: Coronary angiotomography showed high diagnostic validity and can thus be considered as an alternative diagnostic test for studying coronary arterial disease.

Palabras clave: Coronary artery disease. Tomography. Coronary angiography sensitivity and specificity.

2013-07-23   |   520 visitas   |   3 valoraciones

Vol. 63 Núm.1. Enero-Enero 2011 Pags. 18-24 Rev Invest Clin 2011; 63(1-ENGLISH)