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GW24-e0431 Diagnostic value of 320-slice computed tomography angiography in coronary artery stenosis: A meta-analysis
  1. Liao Xue-wen,
  2. Tan Meng-wei,
  3. Li Li
  1. Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University

Abstract

Objectives To evaluate the diagnostic accuracy of 320-slice computed tomography coronary angiography (320-SCTA) compared with the standard reference conventional coronary angiography (CCA) in the detection of significant coronary artery stenosis (≥ 50%).

Methods Relevant studies from December, 2005 to April, 2012 were systematically searched, reviewed and included according to appropriate criteria. Diagnostic accuracy of 320-SCTA was evaluated by the pooled resultes of per-segment, per-vessel, and per-patient analysis, respectively. Meta-regression was employed to explain study heterogeneity.

Results Twenty-eight studies were eligible for this study. In per-segment analysis (n = 13351), pooled sensitivity, specificity, LR +, and LR- were 88.1% (95% CI, 86.5%–89.6%), 97.6% (95% CI, 97.3%-97.8%), 36.2 (95% CI, 28.6–45.9) and 0.11 (95% CI, 0.08–0.16), respectively. In per-vessel analysis (n = 2085), the pooled outcomes of sensitivity, specificity, LR +, and LR- were 87.7% (95% CI, 84.4%–90.5%), 95.4% (95% CI, 94.2%-96.4%), 17.4 (95% CI, 13.9–21.8), and 0.13 (95% CI, 0.07–0.20), respectively. In per-patient analysis (n = 1412), corresponding results were sequentially 95.8% (95% CI, 93.1%–97.7%), 89.2% (95% CI, 85.7%-92.1%), 7.4 (95% CI, 5.6–9.6) and 0.08 (95% CI, 0.05–0.13). The area under the summary receiver operating characteristic curve (AUC) in the per-segment, per-vessel, and per-patient analysis were 0.990, 0.983 and 0.960, respectivity. Percentage of unassessable segments had significant influence on heterogeneity (P = 0.03).

Conclusions The excellent diagnostic performance of 320-SCTA may enable it as an alternative to CCA for the detection of coronary artery stenosis.

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