This author interview is by Dr Amgad N. Makaryus, of North Shore-LIJ Health System. Dr Makaryus' full paper, Multi-Detector Coronary CT Imaging for the Identification of Coronary Artery Stenoses in a "Real-World" Population, is available for download in Clinical Medicine Insights: Cardiology.

First please summarise for readers the content of your article.
Multi-detector computed tomography (MDCT) has emerged as a modality for the non-invasive assessment of coronary artery disease (CAD) and is now an integral part of our diagnostic toolset. Prior studies looking at MDCT have selected specific patients for evaluation and have excluded many of the "real-world" patients commonly encountered in daily practice. These highly selected patients do not represent a "real-world" clini¬cal population of patients. These prior studies have excluded many patients with irregular heart rates, patients with contraindications to beta-blockers where they could have employed other rate-control methods, and many patients with prior history of CAD. Therefore, the aim of our study was to compare MDCT to conven¬tional coronary angiography (CA) to investigate the accuracy of MDCT in determining significant coronary stenoses in a "real-world" clinical population at a busy tertiary care center performing a large number of coronary CT angiography. A total of 1,818 consecutive patients referred for MDCT were evaluated. Patients in whom MDCT results prompted CA investigation were further evaluated, and results of the two diagnostic modalities were compared. A total of 164 coronary arteries and 410 coronary segments were evaluated and the overall per-vessel sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed compared to the gold standard of coronary angiography. We found that MDCT is an accurate imaging tool that allows a non-invasive assessment of significant CAD with a high diagnostic accuracy in a "real-world" population of patients.

How did you come to be involved in your area of study?
North Shore University Hospital in Manhasset, New York, USA, is a busy tertiary care hospital performing a large number of cardiac MDCT in clinical practice. I became involved in this study while directing the cardiology MDCT program at our hospital to evaluate the diagnostic accuracy of MDCT in these patients.

What was previously known about the topic of your article?
Prior studies looking at MDCT have selected specific patients for evaluation and have excluded many of the "real-world" patients commonly encountered in daily practice. These highly selected patients do not represent a "real-world" clini¬cal population of patients. These prior studies have excluded many patients with irregular heart rates (atrial fibrillation, atrial premature contractions, and ventricular premature contractions), patients with contraindications to beta-blockers where they could have employed other rate-control methods, and many patients with prior history of CAD.

How has your work in this area advanced understanding of the topic?
We found that MDCT is an accurate imaging tool that allows a non-invasive assessment of significant CAD with a high diagnostic accuracy in a "real-world" population of patients. The sensitivity and specificity that we noted are not as high as those in prior reports of idealized selected patients.

What do you regard as being the most important aspect of the results reported in the article?
Our report seems to be more realistic of an unselected patient population that is typically encountered in common clinical practice and therefore is more indicative of "real world" results.

Where can readers learn more about your work?
Hospital Webpage: https://www.northshorelij.com/find-care/find-a-doctor/internal-medicine/dr-amgad-nihad-makaryus-md-11317737
LinkedIN: https://www.linkedin.com/in/amgadmakaryus