Читать книгу Interventional Cardiology - Группа авторов - Страница 261

Invasive coronary angiography (ICA) is the gold standard for detection of coronary stenosis (Figure 10.1a). Cardiac computed tomography angiography (CCTA) was developed as a non‐invasive, alternative test to ICA for the same purpose. Numerous studies demonstrated high accuracy of 16‐MSCT and 64‐MSCT compared with ICA [1][4–20]. Three large, multicenter prospective studies demonstrated a sensitivity of 95%, 99%, and 85% respectively of CCTA compared with ICA. The first two included patients without known CAD whereas the last study included patients with and without CAD and with calcium scores of less than 600 [1] [21–23]. While sensitivity and negative predictive values (NPV) have consistently been found to be high with CCTA, positive predictive values have been lower because the modality tends to overestimate disease severity. Therefore, CCTA has been considered an appropriate test to exclude disease in low to intermediate risk patients only [24].