Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Drs Hakeem, Bhatti, and Chapman raise several important issues. The primary objective of the Coronary Assessment by Tomographic Scanning and Catheter Angiography (CATSCAN) study was to measure the diagnostic accuracy of 16-row MDCT for the assessment of stenotic coronary artery disease. The study included patients with intermediate or high probability of coronary artery disease who were referred for coronary angiography. The 32% prevalence of obstructive coronary artery disease, defined as at least 1 segment with luminal narrowing of more than 50%, was lower than anticipated, given that all patients had clinical indications for diagnostic catheterization, and 136 (86%) of the 158 patients who had undergone stress testing prior to enrollment had a positive or equivocal result. We are currently performing subgroup analysis to address the utility of MDCT according to stress test results and clinical stratum.
Garcia MJ. Use of Computed Tomography to Assess Coronary Artery Stenosis—Reply. JAMA. 2006;296(21):2556-2557. doi:10.1001/jama.296.21.2556-b