Salavati A et al. – Dual–source computed tomography–coronary angiography(DSCT–CA) seems to be robust to elevate heart rates while maintaining a high level of diagnostic performance.

• Eight medical databases were searched for articles published from January 2005 through March 2011.
• Studies compared DSCT coronary angiography (DSCT–CA) and invasive coronary angiography, as the reference standard, in consecutive patients with suspected or known CAD, and relevant data were extracted by 2 independent reviewers.
• Summary diagnostic accuracies were calculated, and the effect of covariates on the diagnostic performance was evaluated by meta–regression.

• Twenty–five studies were included.
• In per–patient analysis (n = 2303), pooled sensitivity was 99% [95% confidence interval (CI), 97%–99%] with specificity of 89% (95% CI, 84%–92%).
• The summary positive (+LR) and negative (–LR) likelihood ratios were 8.6 (95% CI, 6.4–11.6) and 0.02 (95% CI, 0.01–0.03), respectively.
• In per–segment analysis (n = 32,615), pooled sensitivity was 94% (95% CI, 92%–96%) with specificity of 97% (95% CI, 96%––98%).
• Summary +LR and –LR were 30.2 (95% CI, 22.1–43.5) and 0.06 (95% CI, 0.04–0.08), respectively.