Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: A multicenter study

Matthew J. Budoff, Demetrios Georgiou, Alan Brody, Arthur S. Agatston, John Kennedy, Christopher Wolfkiel, William Stanford, Paul Shields, Roger J. Lewis, Warren R. Janowitz, Stuart Rich, Bruce H. Brundage

Research output: Contribution to journalArticle

418 Citations (Scopus)

Abstract

Background: Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultrafast CT scanning and coronary angiography in a large number of symptomatic patients. Methods and Results: The study population consisted of 710 patients from six participating centers. A multivariate logistic regression model was used to evaluate the individual contributions of age, number of calcified vessels, and the calcium score for the probability of angiographically significant disease. Of the 710 patients enrolled, 427 patients had significant angiographic disease, and coronary calcification was detected in 404, yielding a sensitivity of 95%. Of the 23 patients without calcifications, 19 (83%) had single-vessel disease at angiography. Of the 283 patients without angiographically significant disease, 124 had negative ultrafast CT coronary studies, for a specificity of 44%. An increasing number of vessels with calcification present on ultrafast CT was found to increase specificity for the presence of obstructive coronary artery disease in at least one vessel (P<.0001). As the log of the calcium score increases, the probability of multivessel obstructive disease increases (P<.0001). Conclusions: Ultrafast CT scanning is a noninvasive, non-exercise- dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.

Original languageEnglish
Pages (from-to)898-904
Number of pages7
JournalCirculation
Volume93
Issue number5
StatePublished - Mar 1 1996
Externally publishedYes

Fingerprint

Multicenter Studies
Coronary Artery Disease
Tomography
Logistic Models
Calcium
Coronary Angiography
Routine Diagnostic Tests
Population
Coronary Disease
Coronary Vessels
Angiography

Keywords

  • coronary disease
  • diagnosis
  • imaging
  • plaque
  • tomography

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Budoff, M. J., Georgiou, D., Brody, A., Agatston, A. S., Kennedy, J., Wolfkiel, C., ... Brundage, B. H. (1996). Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: A multicenter study. Circulation, 93(5), 898-904.

Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease : A multicenter study. / Budoff, Matthew J.; Georgiou, Demetrios; Brody, Alan; Agatston, Arthur S.; Kennedy, John; Wolfkiel, Christopher; Stanford, William; Shields, Paul; Lewis, Roger J.; Janowitz, Warren R.; Rich, Stuart; Brundage, Bruce H.

In: Circulation, Vol. 93, No. 5, 01.03.1996, p. 898-904.

Research output: Contribution to journalArticle

Budoff, MJ, Georgiou, D, Brody, A, Agatston, AS, Kennedy, J, Wolfkiel, C, Stanford, W, Shields, P, Lewis, RJ, Janowitz, WR, Rich, S & Brundage, BH 1996, 'Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: A multicenter study', Circulation, vol. 93, no. 5, pp. 898-904.
Budoff MJ, Georgiou D, Brody A, Agatston AS, Kennedy J, Wolfkiel C et al. Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: A multicenter study. Circulation. 1996 Mar 1;93(5):898-904.
Budoff, Matthew J. ; Georgiou, Demetrios ; Brody, Alan ; Agatston, Arthur S. ; Kennedy, John ; Wolfkiel, Christopher ; Stanford, William ; Shields, Paul ; Lewis, Roger J. ; Janowitz, Warren R. ; Rich, Stuart ; Brundage, Bruce H. / Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease : A multicenter study. In: Circulation. 1996 ; Vol. 93, No. 5. pp. 898-904.
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abstract = "Background: Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultrafast CT scanning and coronary angiography in a large number of symptomatic patients. Methods and Results: The study population consisted of 710 patients from six participating centers. A multivariate logistic regression model was used to evaluate the individual contributions of age, number of calcified vessels, and the calcium score for the probability of angiographically significant disease. Of the 710 patients enrolled, 427 patients had significant angiographic disease, and coronary calcification was detected in 404, yielding a sensitivity of 95{\%}. Of the 23 patients without calcifications, 19 (83{\%}) had single-vessel disease at angiography. Of the 283 patients without angiographically significant disease, 124 had negative ultrafast CT coronary studies, for a specificity of 44{\%}. An increasing number of vessels with calcification present on ultrafast CT was found to increase specificity for the presence of obstructive coronary artery disease in at least one vessel (P<.0001). As the log of the calcium score increases, the probability of multivessel obstructive disease increases (P<.0001). Conclusions: Ultrafast CT scanning is a noninvasive, non-exercise- dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.",
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AU - Stanford, William

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N2 - Background: Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultrafast CT scanning and coronary angiography in a large number of symptomatic patients. Methods and Results: The study population consisted of 710 patients from six participating centers. A multivariate logistic regression model was used to evaluate the individual contributions of age, number of calcified vessels, and the calcium score for the probability of angiographically significant disease. Of the 710 patients enrolled, 427 patients had significant angiographic disease, and coronary calcification was detected in 404, yielding a sensitivity of 95%. Of the 23 patients without calcifications, 19 (83%) had single-vessel disease at angiography. Of the 283 patients without angiographically significant disease, 124 had negative ultrafast CT coronary studies, for a specificity of 44%. An increasing number of vessels with calcification present on ultrafast CT was found to increase specificity for the presence of obstructive coronary artery disease in at least one vessel (P<.0001). As the log of the calcium score increases, the probability of multivessel obstructive disease increases (P<.0001). Conclusions: Ultrafast CT scanning is a noninvasive, non-exercise- dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.

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