One-step anatomic and function testing by cardiac CT versus second-line functional testing in symptomatic patients with coronary artery stenosis : head-to-head comparison of CT-derived fractional flow reserve and myocardial perfusion imaging
BACKGROUND: CT-QFR is a novel coronary computed tomography angiography (CTA)-based method for on-site evaluation of patients with suspected obstructive coronary artery disease (CAD).
AIMS: We aimed to compare the diagnostic performance of CT-QFR with myocardial perfusion scintigraphy (MPS) and cardiovascular magnetic resonance (CMR) as second-line tests in patients with suspected obstructive CAD after coronary CTA.
METHODS: A paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard was carried out. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomised to MPS or CMR and referred for invasive coronary angiography.
RESULTS: The rate of coronary CTA not feasible for CT-QFR analysis was 17%. Paired patient-level data were available for 118 patients in the MPS group and 113 in the CMR group. Patient-level diagnostic accuracy was better for CT-QFR than for both MPS (82.2% [95% CI: 75.2-89.2] vs 70.3% [95% CI: 62.0-78.7], p=0.029) and CMR (77.0% [95% CI: 69.1-84.9] vs 65.5% [95% CI: 56.6-74.4], p=0.047). Following a positive coronary CTA and with the intention to diagnose, CT-QFR, CMR and MPS were equally suitable as rule-in and rule-out modalities.
CONCLUSIONS: The diagnostic performance of CT-QFR as a second-line test was at least similar to MPS and CMR for the evaluation of obstructive CAD in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology - 17(2021), 7 vom: 20. Sept., Seite 576-583 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Westra, Jelmer [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.09.2021 Date Revised 22.02.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.4244/EIJ-D-20-00905 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317638467 |
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| 041 | |a eng | ||
| 100 | 1 | |a Westra, Jelmer |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a One-step anatomic and function testing by cardiac CT versus second-line functional testing in symptomatic patients with coronary artery stenosis |b head-to-head comparison of CT-derived fractional flow reserve and myocardial perfusion imaging |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 27.09.2021 | ||
| 500 | |a Date Revised 22.02.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: CT-QFR is a novel coronary computed tomography angiography (CTA)-based method for on-site evaluation of patients with suspected obstructive coronary artery disease (CAD) | ||
| 520 | |a AIMS: We aimed to compare the diagnostic performance of CT-QFR with myocardial perfusion scintigraphy (MPS) and cardiovascular magnetic resonance (CMR) as second-line tests in patients with suspected obstructive CAD after coronary CTA | ||
| 520 | |a METHODS: A paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard was carried out. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomised to MPS or CMR and referred for invasive coronary angiography | ||
| 520 | |a RESULTS: The rate of coronary CTA not feasible for CT-QFR analysis was 17%. Paired patient-level data were available for 118 patients in the MPS group and 113 in the CMR group. Patient-level diagnostic accuracy was better for CT-QFR than for both MPS (82.2% [95% CI: 75.2-89.2] vs 70.3% [95% CI: 62.0-78.7], p=0.029) and CMR (77.0% [95% CI: 69.1-84.9] vs 65.5% [95% CI: 56.6-74.4], p=0.047). Following a positive coronary CTA and with the intention to diagnose, CT-QFR, CMR and MPS were equally suitable as rule-in and rule-out modalities | ||
| 520 | |a CONCLUSIONS: The diagnostic performance of CT-QFR as a second-line test was at least similar to MPS and CMR for the evaluation of obstructive CAD in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 700 | 1 | |a Li, Zehang |e verfasserin |4 aut | |
| 700 | 1 | |a Rasmussen, Laust Dupont |e verfasserin |4 aut | |
| 700 | 1 | |a Winther, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Guanyu |e verfasserin |4 aut | |
| 700 | 1 | |a Nissen, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Petersen, Steffen E |e verfasserin |4 aut | |
| 700 | 1 | |a Ejlersen, June Anita |e verfasserin |4 aut | |
| 700 | 1 | |a Isaksen, Christin |e verfasserin |4 aut | |
| 700 | 1 | |a Gormsen, Lars Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Urbonaviciene, Grazina |e verfasserin |4 aut | |
| 700 | 1 | |a Eftekhari, Ashkan |e verfasserin |4 aut | |
| 700 | 1 | |a Weng, Tingwen |e verfasserin |4 aut | |
| 700 | 1 | |a Qu, Xinkai |e verfasserin |4 aut | |
| 700 | 1 | |a Bøtker, Hans Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Christiansen, Evald Høj |e verfasserin |4 aut | |
| 700 | 1 | |a Holm, Niels Ramsing |e verfasserin |4 aut | |
| 700 | 1 | |a Bøttcher, Morten |e verfasserin |4 aut | |
| 700 | 1 | |a Tu, Shengxian |e verfasserin |4 aut | |
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