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Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis
BACKGROUND: We sought to evaluate the diagnostic accuracy of 64-slice multi-detector row computed tomography (MDCT) compared with invasive coronary angiography for in-stent restenosis (ISR) detection. METHODS: MEDLINE, Cochrane library, and BioMed Central database searches were performed until April...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866963/ https://www.ncbi.nlm.nih.gov/pubmed/20379863 http://dx.doi.org/10.1007/s12350-010-9218-2 |
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author | Carrabba, Nazario Schuijf, Joanne D. de Graaf, Fleur R. Parodi, Guido Maffei, Erica Valenti, Renato Palumbo, Alessandro Weustink, Annick C. Mollet, Nico R. Accetta, Gabriele Cademartiri, Filippo Antoniucci, David Bax, Jeroen J. |
author_facet | Carrabba, Nazario Schuijf, Joanne D. de Graaf, Fleur R. Parodi, Guido Maffei, Erica Valenti, Renato Palumbo, Alessandro Weustink, Annick C. Mollet, Nico R. Accetta, Gabriele Cademartiri, Filippo Antoniucci, David Bax, Jeroen J. |
author_sort | Carrabba, Nazario |
collection | PubMed |
description | BACKGROUND: We sought to evaluate the diagnostic accuracy of 64-slice multi-detector row computed tomography (MDCT) compared with invasive coronary angiography for in-stent restenosis (ISR) detection. METHODS: MEDLINE, Cochrane library, and BioMed Central database searches were performed until April 2009 for original articles. Inclusion criteria were (1) 64-MDCT was used as a diagnostic test for ISR, with >50% diameter stenosis selected as the cut-off criterion for significant ISR, using invasive coronary angiography and quantitative coronary angiography as the standard of reference; (2) absolute numbers of true positive, false positive, true negative, and false negative results could be derived. Standard meta-analytic methods were applied. RESULTS: Nine studies with a total of 598 patients with 978 stents included were considered eligible. On average, 9% of stents were unassessable (range 0-42%). Accuracy tests with 95% confidence intervals (CIs) comparing 64-MDCT vs invasive coronary angiography showed that pooled sensitivity, specificity, positive and negative likelihood ratio (random effect model) values were: 86% (95% CI 80-91%), 93% (95% CI 91-95%), 12.32 (95% CI 7.26-20.92), 0.18 (95% CI 0.12-0.28) for binary ISR detection. The symmetric area under the curve value was 0.94, indicating good agreement between 64-MDCT and invasive coronary angiography. CONCLUSIONS: 64-MDCT has a good diagnostic accuracy for ISR detection with a particularly high negative predictive value. However, still a relatively large proportion of stents remains uninterpretable. Accordingly, only in selected patients, 64-MDCT may serve as a potential alternative noninvasive method to rule out ISR. |
format | Text |
id | pubmed-2866963 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-28669632010-05-24 Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis Carrabba, Nazario Schuijf, Joanne D. de Graaf, Fleur R. Parodi, Guido Maffei, Erica Valenti, Renato Palumbo, Alessandro Weustink, Annick C. Mollet, Nico R. Accetta, Gabriele Cademartiri, Filippo Antoniucci, David Bax, Jeroen J. J Nucl Cardiol Original Article BACKGROUND: We sought to evaluate the diagnostic accuracy of 64-slice multi-detector row computed tomography (MDCT) compared with invasive coronary angiography for in-stent restenosis (ISR) detection. METHODS: MEDLINE, Cochrane library, and BioMed Central database searches were performed until April 2009 for original articles. Inclusion criteria were (1) 64-MDCT was used as a diagnostic test for ISR, with >50% diameter stenosis selected as the cut-off criterion for significant ISR, using invasive coronary angiography and quantitative coronary angiography as the standard of reference; (2) absolute numbers of true positive, false positive, true negative, and false negative results could be derived. Standard meta-analytic methods were applied. RESULTS: Nine studies with a total of 598 patients with 978 stents included were considered eligible. On average, 9% of stents were unassessable (range 0-42%). Accuracy tests with 95% confidence intervals (CIs) comparing 64-MDCT vs invasive coronary angiography showed that pooled sensitivity, specificity, positive and negative likelihood ratio (random effect model) values were: 86% (95% CI 80-91%), 93% (95% CI 91-95%), 12.32 (95% CI 7.26-20.92), 0.18 (95% CI 0.12-0.28) for binary ISR detection. The symmetric area under the curve value was 0.94, indicating good agreement between 64-MDCT and invasive coronary angiography. CONCLUSIONS: 64-MDCT has a good diagnostic accuracy for ISR detection with a particularly high negative predictive value. However, still a relatively large proportion of stents remains uninterpretable. Accordingly, only in selected patients, 64-MDCT may serve as a potential alternative noninvasive method to rule out ISR. Springer-Verlag 2010-04-09 2010 /pmc/articles/PMC2866963/ /pubmed/20379863 http://dx.doi.org/10.1007/s12350-010-9218-2 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Article Carrabba, Nazario Schuijf, Joanne D. de Graaf, Fleur R. Parodi, Guido Maffei, Erica Valenti, Renato Palumbo, Alessandro Weustink, Annick C. Mollet, Nico R. Accetta, Gabriele Cademartiri, Filippo Antoniucci, David Bax, Jeroen J. Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title_full | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title_fullStr | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title_full_unstemmed | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title_short | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
title_sort | diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: a meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866963/ https://www.ncbi.nlm.nih.gov/pubmed/20379863 http://dx.doi.org/10.1007/s12350-010-9218-2 |
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