Comparison of Computed Tomography Coronary Angiography and Exercise ECG Test for Diagnostic Accuracy in Real-World Practice / 대한내과학회지
Korean Journal of Medicine
;
: 165-172, 2014.
Article
in Korean
| WPRIM
| ID: wpr-226800
ABSTRACT
BACKGROUND/AIMS:
The exercise ECG test (XECG) and computed tomography coronary angiography (CTCA) have been used widely in initial evaluations of coronary artery disease (CAD) in real-world practice. In this study, we compared the diagnostic power of CTCA and XECG, based on conventional coronary angiography (CCA).METHODS:
We enrolled 589 consecutive patients retrospectively who had been examined with both XECG and CTCA for the evaluation of CAD in outpatient clinics. Significant stenosis was defined as more than 50% diameter stenosis. Triage to CCA and/or revascularization treatment (RT) by the results of XECG and CTCA and the diagnostic accuracy of both exams, based on CCA, were investigated.RESULTS:
In the 589 patients, 107 (19%) were triaged to CCA for further evaluation; in 77 (12.8%) significant stenosis was detected on CCA. Also, 65 (11%) patients underwent RT. In the CTCA results, 120 patients had significant stenosis. Of them, 58 (48%) and 75 (62%) patients were triaged to RT and CCA, respectively. Based on the XECG, 115 positive patients were triaged to RT and CCA (23 [20%]/41 [35%]). Among 107 patients with CCA, the sensitivity, specificity, positive predictive value, and negative predictive value for significant stenosis on CCA of CTCA were 89.9%, 74.0%, 90.6%, and 71.4%, respectively, and those of XECG were 50.0, 67.9, 78.0, and 37.3, respectively. The kappa value of CCA and CTCA was 0.62 (p < 0.001) and that of CCA and XECG was 0.145 (p = 0.113).CONCLUSIONS:
In real-world practice, CCA was decided on more frequently, based on CTCA. CTCA showed better diagnostic accuracy than XECG.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Coronary Artery Disease
/
Retrospective Studies
/
Triage
/
Sensitivity and Specificity
/
Coronary Angiography
/
Constriction, Pathologic
/
Electrocardiography
/
Ambulatory Care Facilities
Type of study:
Diagnostic study
/
Observational study
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Medicine
Year:
2014
Type:
Article
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