64-Slice computed tomography (CT) angiography has a high sensitivity and negative predictive value

64-Slice computed tomography (CT) angiography as diagnostic tool in coronary artery disease has been evaluated in a meta analysis by Mowatt et al (Heart 2008;94:1386-1393). Of the 40 studies identified, 28 had sufficient data for incusion in the meta analysis. The studies included were those comparing 64-Slice computed tomography angiography with standard coronary angiography. The pooled data offered a sensitivity of 99% and specificity of 89% taking 50% or more coronary stenosis as a cut off point. The median positive predictive value across studies was 93% (range 64–100%) and negative predictive value 100% (range 86–100%).
The authors suggest that 64-Slice CT angiography may have a role in the assessment of undiagnosed chest pain when simple non-invasive investigations are non-diagnostic and can rule out significant coronary artery disease in this context.

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