JACC: CARDIOVASCULAR IMAGING

VOL.

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),

used QCA stenosis >50% and FFR

Diagnostic Performance of Myocardial CT Perfusion Imaging With or Without Coronary CT Angiography.

Diagnostic Performance of Myocardial CT Perfusion Imaging With or Without Coronary CT Angiography. - PDF Download Free
384KB Sizes 0 Downloads 14 Views

Recommend Documents