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ISCHAEMIC HEART DISEASE
Garcia et al enrolled 238 patients from 11 different hospitals over a nine month period; all had been referred for non-emergency coronary angiography. All patients underwent initial low-dose multidetector computed tomography (MDCT) to evaluate coronary artery calcium, and those with an Agatston score < 600 (187 patients) underwent contrast-enhanced MDCT. Both the MDCT studies and the patients’ subsequent angiograms were analysed by independent core laboratories. Of 1629 non-stented segments larger than 2 mm in diameter, 89 (5.5%) occurred in 59 (32%) of 187 patients with stenosis of more than 50% by conventional angiography. Of the 1629 segments, 71% were evaluable on MDCT. All non-evaluable segments were censored as positive, and this allowed a sensitivity for detecting more than 50% luminal stenosis to be calculated as 89%; specificity 65%; positive predictive value 13%; and negative predictive value 99%. Sensitivity for detecting more than 70% luminal stenosis was 94%; specificity 67%; positive
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