Similar to a recent study posted on 11/18, in this multi-center study of 291 patients with chest pain and suspected CAD, patients underwent both coronary CTA and catheterization (abstract). This study found the PPV of CTA (compared to catheterization) was 91% and the NPV was 83% for detecting >50% coronary artery obstruction (in patients with a BMI<40 and a calcium score <600). From this the authors determined that CTA has “reliable accuracy for the diagnosis of obstructive coronary disease” but also argue that it is not appropriate to replace catheterization with CTA, given it is not a perfect test and given the higher radiation exposure with CTA. Since the diagnostic performance of CTA is study/site/reader-specific, it still remains to be seen the best way to utilize this technology.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.