Technology Comparative Analysis |
|
|
|
Test |
Occlusive CAD Diagnotic Accuracy |
Equipment Cost |
Risk |
Time |
Advantages |
Limitations |
| Conventional Angiogram |
98% |
Highest |
High |
8 hrs |
• Clinical standard for CAD |
• Invasive, expensive, high risk, and time consuming |
| CARDx ECD (12-lead CCG) |
90~94% |
Medium Low |
None |
10 min |
• The only accurate, fast, and non-invasive technology for early detection of CAD, ischemia, microvascular dysfunction, & differentiating heart dsyfunctions |
• Only available for 3D localization of the approximate ischemic area(s) of involved coronary arteries |
| 64-Slice CCTA |
Sensitivity 91~99% Specificity 64~91% |
High |
Moderate |
60 min |
• A useful way of screening for CAD |
• High calcium score |
| • Motion artifact |
| • Safer and faster than conventional angiogram |
• Allergic reaction due to IV contrast injection |
| • Kidney diseases or severe diabetes |
| Stress Thallium SPECT |
Sensitivity 80~90% Specificity 70~75% |
High |
Moderate |
4 hrs |
• Most accurate for ejection fraction |
• Some risk with exercise |
| • Requires IV radio-isotope injection |
| • Best for ischemia detection |
• Expensive |
| Stress Echo-cardiogram |
80% (27% false positive if hypertensive) |
Medium |
Moderate |
30~40 min (technically demanding) |
• Evaluates wall motion & heart under stress |
• Only 80% accurate |
| • Non-invasive |
• Risk of AMI |
| • Good for measuring valvular ejection fraction and left ventricular function |
• Must be ischemic to show abnormalities |
| Echo-cardiogram |
75% |
Medium Low |
None |
15 min |
• Best for valvular, congenital, and wall motion |
• Only 75% accurate for CAD, good images cannot be obtained in 5~15% of patients |
| • Non-invasive |
| • No risks |
| Stress ECG |
50~70% |
Low |
Moderate |
30~40 min |
• Detects perfusion deficit |
• Not recommended if abnormal EKG |
| • Non-invasive |
• Only 42% accurate on women; 33% false positives, 25% false negatives |
| ECG |
40~50% |
Lowest |
None |
10 min |
• Inexpensive |
• Low accuracy |
| • No risk |
• Low specificity |
| • Fast |
• Insensitive to ischemia |
| • Non-invasive |
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