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

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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. / Westra, Jelmer; Li, Zehang; Rasmussen, Laust Dupont et al.

In: EuroIntervention, Vol. 17, No. 7, 09.2021, p. 576-583.

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@article{9a88ed837deb4de089eeb2a10fac9184,
title = "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",
abstract = "AIMS: 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). We compared 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 AND RESULTS: Paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomized to MPS or CMR and referred for invasive coronary angiography. 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, respectively. 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 second-line test was at least similar to MPS and CMR for the evaluation of obstructive coronary artery disease in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA.",
keywords = "ACCURACY, ANGIOGRAPHY, COMPUTED-TOMOGRAPHY, DIAGNOSTIC PERFORMANCE, DISEASE, fractional flow reserve, non-invasive imaging, stable angina",
author = "Jelmer Westra and Zehang Li and Rasmussen, {Laust Dupont} and Simon Winther and Guanyu Li and Louise Nissen and Petersen, {Steffen E} and Ejlersen, {June Anita} and Christin Isaksen and Gormsen, {Lars Christian} and Grazina Urbonaviciene and Ashkan Eftekhari and Tingwen Weng and Xinkai Qu and B{\o}tker, {Hans Erik} and Christiansen, {Evald H{\o}j} and Holm, {Niels Ramsing} and Morten B{\o}ttcher and Shengxian Tu",
year = "2021",
month = sep,
doi = "10.4244/EIJ-D-20-00905",
language = "English",
volume = "17",
pages = "576--583",
journal = "EuroIntervention",
issn = "1774-024X",
publisher = "Europa Digital & Publishing",
number = "7",

}

RIS

TY - JOUR

T1 - One-step anatomic and function testing by cardiac CT versus second-line functional testing in symptomatic patients with coronary artery stenosis

T2 - head-to-head comparison of CT-derived fractional flow reserve and myocardial perfusion imaging

AU - Westra, Jelmer

AU - Li, Zehang

AU - Rasmussen, Laust Dupont

AU - Winther, Simon

AU - Li, Guanyu

AU - Nissen, Louise

AU - Petersen, Steffen E

AU - Ejlersen, June Anita

AU - Isaksen, Christin

AU - Gormsen, Lars Christian

AU - Urbonaviciene, Grazina

AU - Eftekhari, Ashkan

AU - Weng, Tingwen

AU - Qu, Xinkai

AU - Bøtker, Hans Erik

AU - Christiansen, Evald Høj

AU - Holm, Niels Ramsing

AU - Bøttcher, Morten

AU - Tu, Shengxian

PY - 2021/9

Y1 - 2021/9

N2 - AIMS: 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). We compared 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 AND RESULTS: Paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomized to MPS or CMR and referred for invasive coronary angiography. 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, respectively. 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 second-line test was at least similar to MPS and CMR for the evaluation of obstructive coronary artery disease in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA.

AB - AIMS: 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). We compared 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 AND RESULTS: Paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomized to MPS or CMR and referred for invasive coronary angiography. 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, respectively. 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 second-line test was at least similar to MPS and CMR for the evaluation of obstructive coronary artery disease in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA.

KW - ACCURACY

KW - ANGIOGRAPHY

KW - COMPUTED-TOMOGRAPHY

KW - DIAGNOSTIC PERFORMANCE

KW - DISEASE

KW - fractional flow reserve

KW - non-invasive imaging

KW - stable angina

U2 - 10.4244/EIJ-D-20-00905

DO - 10.4244/EIJ-D-20-00905

M3 - Journal article

C2 - 33196446

VL - 17

SP - 576

EP - 583

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 7

ER -