ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
-, NO. -, 2015
ISSN 1936-878X/$36.00
PUBLISHED BY ELSEVIER INC.
LETTER TO THE EDITOR
Twelve studies including 920 patients (median n ¼ 39) and 1,563 coronary vessels (median n ¼ 104) were eligible. Stenosis of 50% (n ¼ 5 studies) or 70%
Diagnostic Performance of Myocardial CT
(n ¼ 2) per QCA and FFR
mation of coronary stenoses. Results of studies
50%) in the main and sensitivity meta-analyses of
attempting to define the diagnostic characteristics
both CTP and CTP/CTA.
of CTP with or without CTA have been variable. In
This bivariate meta-analysis indicated favorable
this meta-analysis, we synthesized available evi-
diagnostic performance of CTP compared with “gold-
dence on the diagnostic performance of CTP with or
standard” invasive methods for CAD assessment.
without coronary CTA in reference to invasive cor-
Addition of CTA to CTP resulted in slightly improved
onary assessment.
specificity without significantly improved sensitivity MEDLINE,
or overall performance. We note the significant het-
EMBASE, and CENTRAL databases using relevant key
erogeneity as a potential limitation of this analysis.
words for studies published before December 2014.
Such degree of heterogeneity can be attributed to
References of eligible studies were perused for addi-
varying pre-test CAD probabilities among the included
tional eligible studies. We included studies evalu-
patient populations, variations in CTP imaging tech-
ating pharmacological stress CTP with or without CTA
niques, and slightly different diagnostic reference
in reference to quantitative coronary angiography
cutoffs. Despite its suggested diagnostic superiority
(QCA) or fractional flow reserve (FFR) for the diag-
compared with single-photon emission computed
nosis of CAD. We only included studies in which
tomography (3), CTP has not yet gained widespread
qualitative perfusion assessment was performed. We
popularity in clinical practice. Although alternative
constructed 4 4 diagnostic performance tables
well-established
adhering to QCA and FFR cutoffs adopted by indi-
remain available (single-photon emission computed
vidual studies for CAD definition. When results for
tomography, positron emission tomography, stress
different cutoffs were available, for consistency we
echocardiography, and cardiac magnetic resonance),