Abstract

Background: Advancing imaging techniques such as CT angiography have provided a good opportunity to the diagnosis of IHD, help decision making on revascularization strategy select good candidates for revascularization, and also to early diagnose postoperative procedural complications. However, the accuracy of this device modality as compared to conventional coronary angiography has remained uncertain. The present study aimed to assess the diagnostic performance of CT angiography versus conventional coronary angiography in predicting appropriate candidates for CABG surgery. Methods: This prospective study was conducted on 49 patients suffering from coronary artery disease and underwent conventional coronary angiography at our heart center in 2018. All subjects were first assessed by 256-slice CT coronary angiography followed by conventional coronary angiography to assess the severity and quality of coronary involvement based on the SYNTAX score. Results:  of 49 patients based on the conventional angiography 27 patients (55/1%) had a score above 22 were considered for CABG and 22 patients (44/8%) had a score below 22 were considered for PCI. Similarly, based on the CT angiography27 patients (55/1%) had a score above 22 were considered for CABG and 22 patients (44/8%) had a score below 22 were considered for PCI. Considering the SYNTAX score determined by conventional angiography as the gold standard. SYNTAX score determined by CT angiography had a sensitivity of 68.4%, a specificity of 80.0%, a PPV of 68.4%, an NPV of 82.7%, and an accuracy of 75.5% for determining the candidates for CABG instead of PCI. According to the area under the ROC curve analysis, determining the SYNTAX score by CT angiography could appropriately discriminate candidates for CABG from those who were candidates for PCI (AUC = 0.765, 95%CI: 0.633 to 0.897, p = 0.002). Conclusion: CT angiography can be a good alternative for invasive coronary angiography for making a good decision for methods of revascularization.