| Title | Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: A meta-analysis |
|---|---|
| Published in | Journal of Nuclear Cardiology, Vol. 17, No. 3, p.470-478. ISSN 1071-3581. |
| Author | Carrabba, N. (Nazario); Schuijf, J.D. (Joanne); De Graaf, F.R. (Fleur R.); Parodi, G. (Guido); Maffei, E. (Erica); Valenti, R. (Renato); Palumbo, A. (Alessandro); Weustink, A.C. (Annick); Mollet, N.R.A. (Nico); Accetta, G. (Gabriele); Cademartiri, F. (Filippo); Antoniucci, D. (David); Bax, J.J. (Jeroen) |
| Date | 2010-06-01 |
| Language | English |
| Type | article |
| Abstract | 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. |
| Publication | http://hdl.handle.net/1765/28352 |
| Persistent Identifier | urn:NBN:nl:ui:15-1765/28352 |
| Metadata | XML |
| Repository | Erasmus University Rotterdam |
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