Head-to-Head Comparison of Dobutamine Stress Echocardiography and Cardiac Computed Tomography for the Detection of Significant Coronary Artery Disease

Recent improvements in the technology of computed tomography (CT) have enabled imaging of the heart and coronary arteries. Electron-beam computed tomography (EBCT) was the first CT modality to provide sufficient temporal resolution for cardiac imaging. In a prospective study design we explore the validity of dobutamine stress echocardiography (DSE) vs EBCT to detect significant CAD (angiographic presence of at least one hemodynamically relevant coronary artery stenosis) by direct comparison. This is the first prospective study on the relative significance of stress echocardiography vs. CAC in addition to non-invasive coronary angiography by a CT modality in a head-to-head comparison. The major finding is the comparable validity of both non-invasive tests, DSE being more specific and EBCT more sensitive. Notably, referral bias can be excluded as stress test results did not indicate coronary angiography. Considering also predictive values and LRs it turned out that DSE seems to be the superior diagnostic procedure if CAD is seriously suspected (typical and severe angina, high risk profile) whereas EBCT (considering CAC and CTA) might be preferred to rule out disease (atypical angina, low risk, and/or young age)

NXDORFF Uwe;  KUEFNER Claudia;  ACHENBACH Stefan;  STILIANAKIS Nikolaos;  VOIGT Jens-Uwe;  FLACHSKAMPF Frank;  DANIEL Werner;  ROPERS Dieter; 

2008-05-19

KARGER

JRC37596

0008-6312,   

https://publications.jrc.ec.europa.eu/repository/handle/JRC37596,   

10.1159/000110484,