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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-3588

Husmann, L; Scheffel, H; Valenta, I; Schepis, T; Gaemperli, O; Aepli, U; Siegrist, P T; Leschka, S; Desbiolles, L; Stolzmann, P; Marincek, B; Alkadhi, H; Kaufmann, P A (2008). Impact of hypertension on the diagnostic accuracy of coronary angiography with computed tomography. International Journal of Cardiovascular Imaging, 24(7):763-770.

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Abstract

Objective Hypertension induces coronary artery disease (CAD) and progression of arterial wall calcification. As coronary calcifications may cause artefacts in 64-slice computed tomography coronary angiography (CTCA), we sought to determine the diagnostic accuracy of CTCA in patients with and without arterial hypertension. Methods Eighty-five consecutive patients with suspected CAD underwent CTCA, calcium-scoring and conventional coronary angiography, and were grouped as hypertensive (28 women, 31 men, mean age 65 +/- 9 years, age range 49-82 years) or normotensive patients (10 women, 16 men, mean age 62 +/- 11 years, age range 39-77 years). On an intention-to-diagnose-basis, no coronary segment was excluded and non-evaluative segments were rated as false positive. Results Per-patient sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the hypertensive group were 91.4, 83.3, 88.9, and 86.9%, while the respective values in the normotensive group were 100, 78.9, 63.6, and 100% (P = 0.42, 0.71, 0.05, and 0.15). In the hypertensive group the prevalence of CAD was 59% and the mean calcium-score was 256; respective values in the normotensive group were 27% and 69, (P < 0.01, and < 0.05 vs. hypertensives). Conclusions Although hypertensives have significantly higher coronary calcifications, sensitivity and specificity are comparably high as in normotensives. The prevalence of CAD is higher in hypertensives and brings about a trend towards a lower NPV and a higher PPV.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
DDC:570 Life sciences; biology
610 Medicine & health
Uncontrolled Keywords:Coronary artery disease - Imaging - Hypertension - Diagnostic accuracy - Prevalence - Coronary angiography - 64-slice computed tomography
Language:English
Date:28 March 2008
Deposited On:26 Sep 2008 09:15
Last Modified:27 Nov 2013 20:37
Publisher:Springer
ISSN:1569-5794
Publisher DOI:10.1007/s10554-008-9307-3
Official URL:http://www.springerlink.com/content/b261g00x333x7676/
PubMed ID:18369738
Citations:Web of Science®. Times Cited: 1
Google Scholar™
Scopus®. Citation Count: 3

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