Diagnostic accuracy of 160-slice CT coronary angiography as compared to invasive coronary angiography keeping invasive coronary angiography as gold standard in patients of coronary artery disease.

Abstract

Objective: To determine diagnostic accuracy of 160 –Slice Computed Tomography (CT) in detection of coronary artery disease in patients with known or suspected coronary artery disease as compared to coronary angiography as a gold standard. Study Design: Cross sectional prospective study. Setting: Tertiary Care Hospital Sargodha. Period: February 2024 to December 2024. Method: The study evaluated 100 patients of both genders with age range of 40 to 80 years, reported with history of angina. The study comprised of patients having known coronary artery disease or suspected coronary artery disease. The patients reported with other cause of chest pain were excluded. Positive angiography was considered to be a significant stenosis of 50 percent or more of lumen diameter. Correlation analysis was used to determine the correlation between Coronary Computed Tomography Angiography (CCTA) and Coronary Invasive Angiography (CIA). Results: 160 – Slice CT was used for 100 patients (70 % male (n=70) and 30 % females (n=30) with mean age 67.4 ± 9.03 years). Oral beta blockers were administered before the scan. Mean interval between Coronary Artery stenting or Bypass Grafting (CABG) surgery and CTA was 9.59 ± 2.7 (range 0 to 20) years. Mean heart rate during scanning was 65.04 ± 4.04 (range 48 to 92) beats/min. 64 % (n=64) patients were CCTA positive and 60 % (n=60) were CIA positive. In comparison to CIA, CCTA showed sensitivity of 95 %, specificity of 82.5 % and accuracy of 90%. Conclusion: 160 – slice CT is a reliable and accurate while performing CCTA in detection of coronary artery stenosis (CAS). Premedication of oral beta blockers improves the study accuracy. CCTA is also reliable in assessing stents and grafts patency. With the help of CCTA, the number of invasive procedures can be reduced.