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Purpose. This study was undertaken to evaluate the diagnostic accuracy of computed tomography coronary angiography (CT-CA) for the detection of significant coronary artery stenosis (≥ 50% lumen reduction) compared with conventional coronary angiography (CCA) in a registry and to review major multicentre trials. Materials and methods. A total of 1,372 patients (882 men, 490 women; mean age 59.3±11.9 years) in sinus rhythm were studied with CT-CA (64-slice technology) and CCA. The diagnostic accuracy of CT-CA was evaluated against quantitative CCA as a reference standard for coronary artery stenosis. Positive and negative likelihood ratios and inter-and intraobserver agreement were calculated.

Results. The prevalence of disease was 53%. CCA demonstrated the absence of significant coronary artery disease in 46.6%(639/1372), single-vessel disease in 24.7%(337/1372) and multivessel disease in 28.9%(396/1372) of patients. In per-patient analysis sensitivity, specificity and positive and negative predictive value of CT-CA were 99%[confidence interval (CI) 97–99], 92%(CI 89–94), 94%(CI 91–95) and 99%(CI 97–99), respectively. Per-patient and per-segment likelihood ratios