Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease.

AIMS: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.

METHODS AND RESULTS: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the chi(2) test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78-97%) and 83% (30 of 36 patients, 95%CI 67-94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57-85%) and 31% (11 of 36 patients, 95%CI 16-48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3-16%) vs. 19% (15 of 80 patients, 95%CI 11-29%)].

CONCLUSION: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.