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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. Gabija Pundziute
  1. Leiden University Medical Center, Netherlands
    1. Joanne D Schuijf
    1. Leiden University Medical Center, Netherlands
      1. J Wouter Jukema
      1. Leiden University Medical Center, Netherlands
        1. Jaap M van Werkhoven
        1. Leiden University Medical Center, Netherlands
          1. Eric Boersma
          1. Erasmus University, Netherlands
            1. Albert de Roos
            1. Leiden University Medical Center, Netherlands
              1. Ernst E van der Wall
              1. Leiden University Medical Center, Netherlands
                1. Jeroen J Bax (j.j.bax{at}lumc.nl)
                1. Leiden University Medical Center, Netherlands

                  Abstract

                  Objective To compare the diagnostic accuracy of 64-slice multi-slice 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 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 due to non-diagnostic MSCT scans as a result of elevated heart rate and breathing during the scan. Accordingly, on segmental level, 728 of 762 coronary segments were of sufficient quality in women (96% (95% CI 95%-97%)) and 704 of 723 segments were interpretable in men (97% (95% CI 96%-98%)). In the remaining 100 patients included in the further analyses, the sensitivity and specificity on segmental level in women and men was 85% (95% CI 75%-95%) vs. 85% (95% CI 78%-92%) and 99% (95% CI 98%-100%) vs. 99% (95% CI 98%-100%), respectively. On a patient level, the sensitivity in women and men was 95% (95% CI 87%-100%) vs. 100%, specificity 93% (95% CI 83%-100%) vs. 89% (95% CI 74%-100%), positive predictive value 91% (95% CI 79%-100%) vs. 94% (95% CI 86%-100%), and negative predictive value 96% (95% CI 89%-100%) vs. 100%, respectively.

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

                  • coronary disease
                  • diagnostic imaging
                  • sensitivity and specificity
                  • women

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