Diagnostic Accuracy of Dual-Energy CT Coronary Angiography for Coronary Stenosis Detection: A Comprehensive Study of Demographics and Comorbidities

Dual-energy computed tomography coronary angiography is a non-invasive method for diagnosing coronary artery disease. Few studies have compared this technique with invasive coronary angiography in Malaysia. This study assessed the accuracy of 128-slice, single-source dual-energy computed tomography coronary angiography compared with invasive coronary angiography in detecting coronary artery stenosis and evaluated the demographics and comorbidities of patients undergoing these procedures. Thirty-five participants underwent both procedures at a private Malaysian medical facility. Two independent radiologists evaluated the diagnostic accuracy for sensitivity, specificity, positive and negative predictive values, and area under the curve. Coronary artery disease was most prevalent in males aged 51-60, with hypercholesterolaemia (85.7%) and hypertension (57.1%) as common comorbidities. Dual-energy computed tomography coronary angiography showed high sensitivity (82.61%-87.50%), specificity (75.00%-90.48%), positive predictive value (82.35%-90.48%), and negative predictive value (69.23%-88.89%) for detecting stenoses in major coronary arteries. AUC values (0.79- 0.88) indicated strong diagnostic accuracy. This study demonstrated that dual-energy computed tomography coronary angiography is an effective non-invasive technique for diagnosing coronary artery stenosis, comparable to invasive coronary angiography. Future studies should optimise scanning protocols for dual-energy computed tomography coronary angiography or investigate its cost-effectiveness in clinical practice.