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Gender influence on the diagnostic accuracy of 64-slice multislice computed tomography coronary angiography for detection of obstructive coronary artery disease

¹ Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
² Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
³ Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania
⁴ The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
⁵ Department of Epidemiology and Statistics, Erasmus University, Rotterdam, The Netherlands

Correspondence to:
Dr J J Bax, Leiden University Medical Centre, Department of Cardiology, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; jbax{at}knoware.nl

ABSTRACT
Objective: To compare the diagnostic accuracy of 64-slice multislice computed tomography (MSCT) coronary angiography between female and male patients using conventional coronary angiography as the reference standard.

Design: Diagnostic accuracy study.

Setting: University hospital.

Patients: 103 consecutive patients (51 men, 52 women, mean (SD) age 60 (10) years) with known and suspected coronary artery disease underwent 64-slice MSCT.

Main outcome measures: Diagnostic accuracy of 64-slice MSCT to detect obstructive (50% luminal narrowing) stenoses in men and women.

Results: One male and two female patients were excluded from the analysis owing to non-diagnostic MSCT scans as a result of increased heart rate and breathing during the scan. Accordingly, on segmental level, 728/762 coronary segments were of sufficient quality in women (96% (95% CI 95% to 97%)) and 704/723 segments were interpretable in men (97% (95% CI 96% to 98%)). In the remaining 100 patients included in the further analyses, the sensitivity and specificity on a segmental level in women and men were 85% (95% CI 75% to 95%) vs 85% (95% CI 78% to 92%) and 99% (95% CI 98% to 100%) vs 99% (95% CI 98% to 100%), respectively. On a patient level, the sensitivity in women and men was 95% (95% CI 87% to 100%) vs 100%, specificity 93% (95% CI 83% to 100%) vs 89% (95% CI 74% to 100%), positive predictive value 91% (95% CI 79% to 100%) vs 94% (95% CI 86% to 100%), and negative predictive value 96% (95% CI 89% to 100%) vs 100%, respectively.

Conclusion: The findings confirm the high diagnostic accuracy of 64-slice MSCT coronary angiography in both male and female patients.

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