Comparative diagnostic performance of coronary CT angiography and invasive coronary angiography in patients with suspected coronary artery disease.

Abstract

Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Although invasive coronary angiography (ICA) is the reference standard for diagnosing CAD, coronary computed tomography angiography (CCTA) has emerged as a valuable non-invasive alternative. This study compared the diagnostic performance of CCTA with ICA in patients with suspected CAD.

Methods: In this descriptive cross-sectional study, 155 patients who underwent both CCTA and ICA were included. Coronary stenosis was classified as mild (1-49%), moderate (50-69%), or severe (≥ 70%). ICA served as the reference standard. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.

Results: The mean age of the patients was 57.3 ± 9.15 years, and 67.7% were male. CCTA demonstrated a sensitivity of 96.0%, specificity of 33.3%, PPV of 85.7%, NPV of 66.7%, and an overall accuracy of 83.9%. The LAD showed the highest vessel-based sensitivity (87%), whereas the LCX had the lowest (60%). CCTA correctly identified all cases of moderate stenosis and detected 69% of severe stenoses.

Conclusion: CCTA demonstrated high sensitivity for detecting CAD but relatively limited specificity in this high-risk population. These findings support its role as a useful non-invasive diagnostic tool, while ICA remains the reference standard for confirming coronary artery stenosis.