The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability

European Heart Journal
Juhani KnuutiWilliam Wijns

Abstract

To determine the ranges of pre-test probability (PTP) of coronary artery disease (CAD) in which stress electrocardiogram (ECG), stress echocardiography, coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance (CMR) can reclassify patients into a post-test probability that defines (>85%) or excludes (<15%) anatomically (defined by visual evaluation of invasive coronary angiography [ICA]) and functionally (defined by a fractional flow reserve [FFR] ≤0.8) significant CAD. A broad search in electronic databases until August 2017 was performed. Studies on the aforementioned techniques in >100 patients with stable CAD that utilized either ICA or ICA with FFR measurement as reference, were included. Study-level data was pooled using a hierarchical bivariate random-effects model and likelihood ratios were obtained for each technique. The PTP ranges for each technique to rule-in or rule-out significant CAD were defined. A total of 28 664 patients from 132 studies that used ICA as reference and 4131 from 23 studies using FFR, were analysed. Stress ECG can rule-in and rule-out anatomically significant CAD only when PTP is ≥80% (...Continue Reading

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Citations

Jul 26, 2019·Current Cardiology Reports·Pupalan IyngkaranSharmalar Rajendran
Dec 12, 2018·European Heart Journal·Thomas F Lüscher
Apr 27, 2020·European Heart Journal Cardiovascular Imaging·Wail Nammas, Antti Saraste
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Sep 11, 2019·European Heart Journal·Juhani KnuutiUNKNOWN ESC Scientific Document Group
Oct 24, 2019·European Heart Journal Cardiovascular Imaging·Antti SarasteJuhani Knuuti
Jul 18, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Jay N ShahMylan C Cohen
Aug 11, 2020·Current Cardiology Reports·Riccardo Liga, Danilo Neglia
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Apr 16, 2019·European Heart Journal Cardiovascular Imaging·Luis Eduardo Juarez-OrozcoJuhani Knuuti
Mar 25, 2019·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Andrea G Monroy-GonzalezErick Alexanderson-Rosas
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