NEW YORK (Reuters Health) – For patients with suspected coronary artery disease (CAD), three-dimensional coronary magnetic resonance angiography is an accurate noninvasive method for identifying disease of the proximal and middle coronary artery segments.
The finding, reported in the December 27th issue of The New England Journal of Medicine, suggests that noninvasive diagnostic cardiology techniques may one day replace invasive techniques for some patients.
Dr. Warren J. Manning from Beth Israel Deaconess Medical Center, Boston, and colleagues performed coronary magnetic resonance angiography in 109 men and women, before the subjects underwent elective x-ray coronary angiogram, and compared the results.
The researchers looked at 636 proximal and middle segments of coronary arteries using coronary magnetic resonance angiography. In these segments, 78 (83%) of the 94 clinically significant lesions identified by x-ray coronary angiography were also found by magnetic resonance angiography.
Three-dimensional coronary magnetic resonance angiography had an overall accuracy of 72%. For patients with left main coronary artery disease or three-vessel disease the sensitivity of three-dimensional coronary magnetic resonance angiography was 100%, specificity was 85% and accuracy was 87%, the researchers report.
For any CAD, the negative predictive value of three-dimensional coronary magnetic resonance angiography was 81%, and for left main artery disease or three-vessel disease it was 100%, Dr. Manning's team found.
"In this prospective, multicenter study…we found that coronary magnetic resonance angiography had a high sensitivity, negative predictive value and overall accuracy for detecting coronary disease, especially in subjects with left main coronary artery disease or three-vessel disease," Dr. Manning and colleagues conclude.
"Will noninvasive coronary angiography become an acceptable alternative to the standard, invasive approach?" Drs. Stephan Achenbach and Werner G. Daniel from the University of Erlangen, Germany ask in an editorial. "With impressive recent advances, the issue should be not if, but when and for which patients," they answer.
N Engl J Med 2001;345:1863-1869.
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