Prediction of Coronary Revascularization in Stable Angina
| Autor: | Simon Winther, Majed Husain, Steffen E. Petersen, Lone Deibjerg, Niels Peter Rønnow Sand, Morten Bøttcher, Hans Erik Bøtker, Louise Nissen, Allan Rohold, Grazina Urbonaviciene, Jelmer Westra, Niels Ramsing Holm, Pia Veldt Larsen, Kristian Korsgaard Thomsen, Evald Høj Christiansen, Christin Isaksen |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Ischemia Fractional flow reserve 030204 cardiovascular system & hematology Chest pain medicine.disease Revascularization 030218 nuclear medicine & medical imaging Coronary artery disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Internal medicine medicine Cardiology Radiology Nuclear Medicine and imaging cardiovascular diseases medicine.symptom Cardiology and Cardiovascular Medicine business Prospective cohort study Perfusion Artery |
| Zdroj: | JACC: Cardiovascular Imaging. 13:994-1004 |
| ISSN: | 1936-878X |
| Popis: | Objectives This study was designed to compare head-to-head fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFRCT) and cardiac magnetic resonance (CMR) stress perfusion imaging for prediction of standard-of-care–guided coronary revascularization in patients with stable chest pain and obstructive coronary artery disease by coronary CTA. Background FFRCT is a novel modality for noninvasive functional testing. The clinical utility of FFRCT compared to CMR stress perfusion imaging in symptomatic patients with coronary artery disease is unknown. Methods Prospective study of patients (n=110) with stable angina pectoris and 1 or more coronary stenosis ≥50% by coronary CTA. All patients underwent invasive coronary angiography. Revascularization was FFR-guided in stenoses ranging from 30% to 90%. FFRCT ≤0.80 in 1 or more coronary artery or a reversible perfusion defect (≥2 segments) by CMR categorized patients with ischemia. FFRCT and CMR were analyzed by core laboratories blinded for patient management. Results A total of 38 patients (35%) underwent revascularization. Per-patient diagnostic performance for identifying standard-of-care–guided revascularization, (95% confidence interval) yielded a sensitivity of 97% (86 to 100) for FFRCT versus 47% (31 to 64) for CMR, p 0.05, respectively. Conclusions In patients with stable chest pain referred to invasive coronary angiography based on coronary CTA, FFRCT and CMR yielded similar overall diagnostic accuracy. Sensitivity for prediction of revascularization was highest for FFRCT, whereas specificity was highest for CMR. |
| Databáze: | OpenAIRE |
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