CT Perfusion Versus Coronary CT Angiography in Patients With Suspected In-Stent Restenosis or CAD Progression
Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: The goal of this study was to assess the diagnostic performance of coronary computed tomography angiography (CTA) alone, adenosine-stress myocardial perfusion assessed by computed tomography (CTP) alone, and coronary CTA + CTP by using a 16-cm Z-axis coverage scanner versus invasive coronary angiography (ICA) and fractional flow reserve (FFR) as the clinical standard.
BACKGROUND: Diagnostic performance of coronary CTA for in-stent restenosis detection is still challenging. Recently, CTP showed additional diagnostic power over coronary CTA in patients with suspected coronary artery disease. However, few data are available on CTP performance in patients with previous stent implantation.
METHODS: Consecutive stable patients with previous coronary stenting referred for ICA were enrolled. All patients underwent stress myocardial CTP and rest CTP + coronary CTA. Invasive FFR was performed during ICA when clinically indicated. The diagnostic rate and diagnostic accuracy of coronary CTA, CTP, and coronary CTA + CTP were evaluated in stent-, territory-, and patient-based analyses.
RESULTS: In the 150 enrolled patients (132 men; mean age 65.1 ± 9.1 years), the CTP diagnostic rate was significantly higher than that of coronary CTA in all analyses (territory based [96.7% vs. 91.1%; p < 0.0001] and patient based [96% vs. 68%; p < 0.0001]). When ICA was used as gold standard, CTP diagnostic accuracy was significantly higher than that of coronary CTA in all analyses (territory based [92.1% vs. 85.5%, p < 0.03] and patient based [86.7% vs. 76.7%, p < 0.03]). The concordant coronary CTA + CTP assessment exhibited the highest diagnostic accuracy values versus ICA (95.8% in the territory-based analysis). The diagnostic accuracy of CTP was significantly higher than that of coronary CTA (75% vs. 30.5%; p < 0.001). The radiation exposure of coronary CTA + CTP was 4.15 ± 1.5 mSv.
CONCLUSIONS: In patients with coronary stents, CTP significantly improved the diagnostic rate and accuracy of coronary CTA alone compared with both ICA and invasive FFR as gold standard.
| Errataetall: |
CommentIn: JACC Cardiovasc Imaging. 2020 Mar;13(3):743-745. - PMID 31422144 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
|---|---|
| Enthalten in: |
JACC. Cardiovascular imaging - 13(2020), 3 vom: 01. März, Seite 732-742 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Andreini, Daniele [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adenosine |
|---|
| Anmerkungen: |
Date Completed 10.11.2020 Date Revised 10.11.2020 published: Print-Electronic CommentIn: JACC Cardiovasc Imaging. 2020 Mar;13(3):743-745. - PMID 31422144 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jcmg.2019.05.031 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM300323581 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM300323581 | ||
| 003 | DE-627 | ||
| 005 | 20231225102255.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jcmg.2019.05.031 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1001.xml |
| 035 | |a (DE-627)NLM300323581 | ||
| 035 | |a (NLM)31422127 | ||
| 035 | |a (PII)S1936-878X(19)30590-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Andreini, Daniele |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a CT Perfusion Versus Coronary CT Angiography in Patients With Suspected In-Stent Restenosis or CAD Progression |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.11.2020 | ||
| 500 | |a Date Revised 10.11.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: JACC Cardiovasc Imaging. 2020 Mar;13(3):743-745. - PMID 31422144 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: The goal of this study was to assess the diagnostic performance of coronary computed tomography angiography (CTA) alone, adenosine-stress myocardial perfusion assessed by computed tomography (CTP) alone, and coronary CTA + CTP by using a 16-cm Z-axis coverage scanner versus invasive coronary angiography (ICA) and fractional flow reserve (FFR) as the clinical standard | ||
| 520 | |a BACKGROUND: Diagnostic performance of coronary CTA for in-stent restenosis detection is still challenging. Recently, CTP showed additional diagnostic power over coronary CTA in patients with suspected coronary artery disease. However, few data are available on CTP performance in patients with previous stent implantation | ||
| 520 | |a METHODS: Consecutive stable patients with previous coronary stenting referred for ICA were enrolled. All patients underwent stress myocardial CTP and rest CTP + coronary CTA. Invasive FFR was performed during ICA when clinically indicated. The diagnostic rate and diagnostic accuracy of coronary CTA, CTP, and coronary CTA + CTP were evaluated in stent-, territory-, and patient-based analyses | ||
| 520 | |a RESULTS: In the 150 enrolled patients (132 men; mean age 65.1 ± 9.1 years), the CTP diagnostic rate was significantly higher than that of coronary CTA in all analyses (territory based [96.7% vs. 91.1%; p < 0.0001] and patient based [96% vs. 68%; p < 0.0001]). When ICA was used as gold standard, CTP diagnostic accuracy was significantly higher than that of coronary CTA in all analyses (territory based [92.1% vs. 85.5%, p < 0.03] and patient based [86.7% vs. 76.7%, p < 0.03]). The concordant coronary CTA + CTP assessment exhibited the highest diagnostic accuracy values versus ICA (95.8% in the territory-based analysis). The diagnostic accuracy of CTP was significantly higher than that of coronary CTA (75% vs. 30.5%; p < 0.001). The radiation exposure of coronary CTA + CTP was 4.15 ± 1.5 mSv | ||
| 520 | |a CONCLUSIONS: In patients with coronary stents, CTP significantly improved the diagnostic rate and accuracy of coronary CTA alone compared with both ICA and invasive FFR as gold standard | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a coronary CT angiography | |
| 650 | 4 | |a coronary stents | |
| 650 | 4 | |a invasive coronary angiography | |
| 650 | 4 | |a static CT perfusion | |
| 650 | 7 | |a Vasodilator Agents |2 NLM | |
| 650 | 7 | |a Adenosine |2 NLM | |
| 650 | 7 | |a K72T3FS567 |2 NLM | |
| 700 | 1 | |a Mushtaq, Saima |e verfasserin |4 aut | |
| 700 | 1 | |a Pontone, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Conte, Edoardo |e verfasserin |4 aut | |
| 700 | 1 | |a Collet, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Sonck, Jeroen |e verfasserin |4 aut | |
| 700 | 1 | |a D'Errico, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Di Odoardo, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Guglielmo, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Baggiano, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Trabattoni, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Ravagnani, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Montorsi, Piero |e verfasserin |4 aut | |
| 700 | 1 | |a Teruzzi, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Olivares, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Fabbiocchi, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a De Martini, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Calligaris, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Annoni, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Mancini, Maria Elisabetta |e verfasserin |4 aut | |
| 700 | 1 | |a Formenti, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Magatelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Consiglio, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a Muscogiuri, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Lombardi, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Fiorentini, Cesare |e verfasserin |4 aut | |
| 700 | 1 | |a Bartorelli, Antonio L |e verfasserin |4 aut | |
| 700 | 1 | |a Pepi, Mauro |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t JACC. Cardiovascular imaging |d 2008 |g 13(2020), 3 vom: 01. März, Seite 732-742 |w (DE-627)NLM186259573 |x 1876-7591 |7 nnns |
| 773 | 1 | 8 | |g volume:13 |g year:2020 |g number:3 |g day:01 |g month:03 |g pages:732-742 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jcmg.2019.05.031 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 13 |j 2020 |e 3 |b 01 |c 03 |h 732-742 | ||