Incremental diagnostic accuracy of computed tomography myocardial perfusion imaging over coronary angiography stratified by pre-test probability of coronary artery disease and severity of coronary artery calcification: The CORE320 study

International Journal of Cardiology
Ravi K SharmaJoăo A C Lima

Abstract

Myocardial CT perfusion (CTP) has been validated as an incremental diagnostic predictor over coronary computed tomography angiography (CTA) in assessing hemodynamically significant stenosis. To assess the diagnostic performance of CTA and CTP alone versus combined CTA-CTP stratified by Morise's pre-test probability and coronary artery calcium (CAC, Agatston) score. 381 individuals (153 low/intermediate-risk for CAD, 83 high-risk, 145 known CAD) were further stratified based on CAC score cut-offs of 1-399 and ≥400. Area under the curve for receiver operating characteristics (AUC) was calculated to assess the diagnostic performance. Reference standards were QCA≥50% stenosis+corresponding SPECT summed stress score ≥1. In both pre-test risk groups with an Agatston score of 1-399, AUCs of CTA-CTP were not significantly different than that from CTA alone. In the low/intermediate-risk group with CAC score 1-399, AUC for CTA-CTP (89) was higher than that for CTP (76, p=0.003) alone. In the same group with CAC score ≥400, AUCs were higher for CTA-CTP (97) than that for CTA (88, p=0.030) and CTP (83, p=0.033). In high risk/known CAD patients with CAC 1-399, diagnostic performance for CTA-CTP (77) was superior to CTP (71, p=0.037) alone. ...Continue Reading

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Citations

Feb 13, 2016·The British Journal of Radiology·Erica MaffeiFilippo Cademartiri
Jan 20, 2016·Current Cardiology Reports·Mhairi Doris, David E Newby
Jan 18, 2016·Revista Española De Cardiología·Sara SeitunCarlo Ferro
Oct 19, 2017·European Heart Journal Cardiovascular Imaging·Joanne D SchuijfJoão A C Lima
May 16, 2019·Journal of Breath Research·Michael PhillipsHarvey I Pass
Nov 9, 2018·BioMed Research International·Sara SeitunGian Paolo Bezante
Feb 7, 2020·Japanese Journal of Radiology·Yuki TanabePrabhakar Rajiah
Sep 19, 2019·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Mohammed El MahdiuiArthur J H A Scholte
Jun 6, 2021·International Journal of Cardiology·Jesse Habets

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