Detection of Significant Coronary Artery Disease by Noninvasive Anatomical and Functional Imaging
| Autor: | Neglia, D., Rovai, D., Caselli, C., Pietila, M., Teresinska, A., Aguade-Bruix, S., Pizzi, M.N., Todiere, G., Gimelli, A., Schroeder, S., Drosch, T., Poddighe, R., Casolo, G., Anagnostopoulos, C., Pugliese, F., Rouzet, F., Guludec, D. le, Cappelli, F., Valente, S., Gensini, G.F., Zawaideh, C., Capitanio, S., Sambuceti, G., Marsico, F., Filardi, P.P., Fernandez-Golfin, C., Rincon, L.M., Graner, F.P., Graaf, M.A. de, Fiechter, M., Stehli, J., Gaemperli, O., Reyes, E., Nkomo, S., Maki, M., Lorenzoni, V., Turchetti, G., Carpeggiani, C., Marinelli, M., Puzzuoli, S., Mangione, M., Marcheschi, P., Mariani, F., Giannessi, D., Nekolla, S., Lombardi, M., Sicari, R., Scholte, A.J.H.A., Zamorano, J.L., Kaufmann, P.A., Underwood, S.R., Knuuti, J., EVINCI Study Investigators |
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| Přispěvatelé: | Neglia, Danilo, Rovai, Daniele, Caselli, Chiara, Pietila, Mikko, Teresinska, Anna, Aguadé Bruix, Santiago, Pizzi, Maria Nazarena, Todiere, Giancarlo, Gimelli, Alessia, Schroeder, Stephen, Drosch, Tanja, Poddighe, Rosa, Casolo, Giancarlo, Anagnostopoulos, Constantino, Pugliese, Francesca, Rouzet, Francoi, Le Guludec, Dominique, Cappelli, Francesco, Valente, Serafina, Gensini, Gian Franco, Zawaideh, Camilla, Capitanio, Selene, Sambuceti, Gianmario, Marsico, Fabio, PERRONE FILARDI, Pasquale, Fernández Golfín, Covadonga, Rincón, Luis M, Graner, Frank P, de Graaf, Michiel A, Fiechter, Michael, Stehli, Julia, Gaemperli, Oliver, Reyes, Eliana, Nkomo, Sandy, Mäki, Maija, Lorenzoni, Valentina, Turchetti, Giuseppe, Carpeggiani, Clara, Marinelli, Martina, Puzzuoli, Stefano, Mangione, Maurizio, Marcheschi, Paolo, Mariani, Fabio, Giannessi, Daniela, Nekolla, Stephan, Lombardi, Massimo, Sicari, Rosa, Scholte, Arthur J. H. A, Zamorano, José L, Kaufmann, Philipp A, Underwood, S. Richard, Knuuti, Juhani, University of Zurich |
| Rok vydání: | 2015 |
| Předmět: |
Male
Comparative Effectiveness Research positron emission tomography Coronary Stenosi Predictive Value of Test Fractional flow reserve Single-photon emission computed tomography Coronary Angiography Chest pain coronary artery disease coronary computed tomography angiography echocardiography magnetic resonance imaging myocardial perfusion imaging single photon computed emission tomography Aged Area Under Curve Coronary Artery Disease Coronary Stenosis Europe Female Fractional Flow Reserve Myocardial Humans Middle Aged Myocardial Perfusion Imaging Predictive Value of Tests Prevalence Prospective Studies ROC Curve Severity of Illness Index Ventricular Function Echocardiography Stress Magnetic Resonance Imaging Positron-Emission Tomography Tomography Emission-Computed Single-Photon Tomography X-Ray Computed Coronary artery disease Medicine 610 Medicine & health Tomography medicine.diagnostic_test Fractional Flow Reserve X-Ray Computed Positron emission tomography Coronary vessel Radiology medicine.symptom Cardiology and Cardiovascular Medicine Human medicine.medical_specialty Stress 2705 Cardiology and Cardiovascular Medicine Myocardial perfusion imaging Echocardiography Stre 2741 Radiology Nuclear Medicine and Imaging Myocardial Radiology Nuclear Medicine and imaging ta3126 business.industry Magnetic resonance imaging 10181 Clinic for Nuclear Medicine ta3121 medicine.disease Prospective Studie Emission-Computed business Single-Photon |
| Zdroj: | Circulation: Cardiovascular Imaging, 8(3) |
| ISSN: | 1942-0080 1941-9651 |
| DOI: | 10.1161/circimaging.114.002179 |
| Popis: | Background— The choice of imaging techniques in patients with suspected coronary artery disease (CAD) varies between countries, regions, and hospitals. This prospective, multicenter, comparative effectiveness study was designed to assess the relative accuracy of commonly used imaging techniques for identifying patients with significant CAD. Methods and Results— A total of 475 patients with stable chest pain and intermediate likelihood of CAD underwent coronary computed tomographic angiography and stress myocardial perfusion imaging by single photon emission computed tomography or positron emission tomography, and ventricular wall motion imaging by stress echocardiography or cardiac magnetic resonance. If ≥1 test was abnormal, patients underwent invasive coronary angiography. Significant CAD was defined by invasive coronary angiography as >50% stenosis of the left main stem, >70% stenosis in a major coronary vessel, or 30% to 70% stenosis with fractional flow reserve ≤0.8. Significant CAD was present in 29% of patients. In a patient-based analysis, coronary computed tomographic angiography had the highest diagnostic accuracy, the area under the receiver operating characteristics curve being 0.91 (95% confidence interval, 0.88–0.94), sensitivity being 91%, and specificity being 92%. Myocardial perfusion imaging had good diagnostic accuracy (area under the curve, 0.74; confidence interval, 0.69–0.78), sensitivity 74%, and specificity 73%. Wall motion imaging had similar accuracy (area under the curve, 0.70; confidence interval, 0.65–0.75) but lower sensitivity (49%, P P P Conclusions— In a multicenter European population of patients with stable chest pain and low prevalence of CAD, coronary computed tomographic angiography is more accurate than noninvasive functional testing for detecting significant CAD defined invasively. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00979199. |
| Databáze: | OpenAIRE |
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