Background
CAD is the main cause of death
in industrialised
countries [6]. For that reason, an early detection as well as an
appropriate
method to rule out the presence of CAD is very important. In addition,
a
reliable and noninvasive test would offer big advantages for the
patient.
Conventional coronary angiography
(CCA) represents the gold standard when the presence of CAD is
suspected, although
in almost 60% of the cases no revascularisation is necessary and the
invasive
examination only serves a diagnostic purpose [5]. CT has become the
most frequently
used alternative imaging modality to CCA and offers two important
advantages:
First, the examination is noninvasive, which considerably reduces the
risk for
the patient and, secondly, from an economical point of view, the
examination is
more cost-effective [9].
A meta-analysis by our group pooling
the results of several studies has shown that the accuracy of CT in
patients
with a low to intermediate pretest likelihood of CAD is quite high (97%
sensitivity, 87% specificity) [8]. These patients are most likely to
benefit
from a CT examination and a negative CT result
excludes the
presence of CAD with very high certainty [4, 7]. Nevertheless, previous
studies
and meta-analyses had to rely on limited summary patient data. By
performing an
IPD meta-analysis, we will be able to carry out a more detailed and
powerful
analysis and thus increase the generalisability of the results.