SynthesisThe international journal of cardiovascular imaging2012
Influence of coronary calcification on the diagnostic accuracy of 64-slice computed tomography coronary angiography: a systematic review and meta-analysis.
Synthesis in The international journal of cardiovascular imaging, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02011061 (Prospective International Study of Coronary Substraction Using 320 Row-detector CT), which is not on this map. Cited by 57 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective International Study of Coronary Substraction Using 320 Row-detector CT
Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Diagnostic accuracy of coronary angiography using 64-slice computed tomography in coronary artery disease.Saudi medical journal · 2015Pooled it
- Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis.European radiology · 2012Pooled it
- Korean guidelines for the appropriate use of cardiac CT.Korean journal of radiologyGuideline
- Nonlinear and Vessel-Specific Association Between Coronary Artery Calcium Burden and Coronary Computed Tomography Angiography Underestimation of Coronary Stenosis.Reviews in cardiovascular medicine · 2026Article
- Diagnostic Performance of Photon-Counting CT Angiography in Vascular Stenosis Assessment: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Dark-blood" Imaging in Coronary CT Angiography Using Dual layer Detector Spectral CT: Effect on Image Quality and Vessel Wall VisibilityCurrent medical imaging · 2026Article
- Preoperative cardiovascular evaluation in patients with cancer.Frontiers in cardiovascular medicine · 2026Review
- Article
- Incidence and predictors of discrepancies in radiology resident interpretations of coronary CT in the emergency department.BMC medical imaging · 2025Article
- Artificial Intelligence based fractional flow reserve.Cardiology journal · 2025Review
- Evolving Role of Coronary CT Angiography in Coronary Angiography and Intervention: A State-of-the-Art Review.Current cardiology reports · 2024Review
- The Role of Coronary Computed Tomography Angiography in the Diagnosis, Risk Stratification, and Management of Patients with Diabetes and Chest Pain.Reviews in cardiovascular medicine · 2024Review
- [Assessment of Coronary Stenosis Using Coronary CT Angiography in Patients with High Calcium Scores: Current Limitations and Future Perspectives].Journal of the Korean Society of Radiology · 2024Review
- Image navigator-based, automated coronary magnetic resonance angiography for the detection of coronary artery stenosis.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Article
- The Value of Coronary Computed Tomography Angiography in Patients with a High Calcium Score.The journal of Tehran Heart Center · 2023Article
- Pre-screening for non-diagnostic coronary computed tomography angiography.European heart journal. Imaging methods and practice · 2023Article
- Article
- Incremental diagnostic value of perivascular fat attenuation index for identifying hemodynamically significant ischemia with severe calcification.The international journal of cardiovascular imaging · 2023Article
- Predictive values of coronary artery calcium and arterial stiffness for long-term cardiovascular events in patients with stable coronary artery disease.Clinical cardiology · 2023Article
- The novel HFrontiers in cardiovascular medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To determine via meta-analysis the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTA) for assessment of significant obstructive coronary artery stenosis at different coronary artery calcium score (CACS) levels. Data of 12,053 versus 5,890 segments, 906 versus 758 arteries and 1,120 versus 514 patients in low versus high CACS subgroups from 19 eligible studies were compared. The per-patient prevalence of coronary artery disease was 48% versus 68%, respectively. Subgroups were stratified by different CACS thresholds ranging from 100 to 400. Meta-analyses of per-patient data comparing overall low versus high CACS subgroups resulted in a sensitivity of 97.5 (95.5-99)% versus 97 (94.5-98.5)%, specificity of 85 (82-88)% versus 66.5 (58-74.5)%, diagnostic odds ratio of 153 (81-290) versus 40 (20-83), positive predictive value of 85 (82-87)% versus 86 (84-88)%, negative predictive value of 97.5 (95-99)% versus 91 (88-94)% and overall accuracy of 91% versus 89% with 95% confidence interval, respectively. The drop in specificity was significant (P = 0.035), while the sensitivity and overall accuracy were insignificantly changed (P > 0.05). Meta-analyses of independent subgroups at CACS levels ≤10 and ≤100 demonstrated high specificities of 90 (94-100)% and 88.5 (81-91.5)%, whereas at CACS levels ≥400 the specificity declined significantly to 42 (28-56)% but with consistently retained high sensitivity of 97.5 (94-99)%. The specificity of CTA decreases with increasing CACS, while the sensitivity remains high independent of that. The suggested CACS thresholds are arbitrary and do not necessarily warrant cancelling angiography. Diagnostic studies are needed to explore whether a specific CACS threshold may serve as a pre-angiographic gatekeeper to prevent likely equivocal angiographies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.