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Cardiac imaging and non-invasive testing
Gender influence on the diagnostic accuracy of 64-slice multislice computed tomography coronary angiography for detection of obstructive coronary artery disease
  1. G Pundziute1,3,
  2. J D Schuijf1,
  3. J W Jukema1,4,
  4. J M van Werkhoven1,
  5. E Boersma5,
  6. A de Roos2,
  7. E E van der Wall1,4,
  8. J J Bax1
  1. 1
    Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
  2. 2
    Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3
    Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania
  4. 4
    The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
  5. 5
    Department of Epidemiology and Statistics, Erasmus University, Rotterdam, The Netherlands
  1. Dr J J Bax, Leiden University Medical Centre, Department of Cardiology, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; jbax{at}


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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  • Funding: GP is financially supported by the training fellowship grant of the European Society of Cardiology, Huygens scholarship and Toshiba Medical Systems Europe. JWJ is an established investigator of the Netherlands Heart Foundation, grant number 2001T032. JJ Bax has received research grants from GE Healthcare and BMS Medical Imaging.

  • Competing interests: None declared.