Portal de Periódicos da CAPES

One-step anatomic and function testing by cardiac CT versus second-line functional testing in symptomatic patients with coronary artery stenosis: head-to-head comparison of CT-derived fractional flow reserve and myocardial perfusion imaging

2021; European Association of Percutaneous Cardiovascular Interventions; Volume: 17; Issue: 7 Linguagem: Inglês

10.4244/eij-d-20-00905

1969-6213

Jelmer Westra, Zehang Li, Laust Dupont Rasmussen, Simon Winther, Guanyu Li, Louise Nissen, Steffen E. Petersen, June Anita Ejlersen, Christin Isaksen, Lars Christian Gormsen, Gražina Urbonavičienė, Ashkan Eftekhari, Tingwen Weng, Xinkai Qu, Hans Erik Bøtker, Evald Høj Christiansen, Niels Ramsing Holm, Morten Bøttcher, Shengxian Tu,

Advanced MRI Techniques and Applications

Background: CT-QFR is a novel coronary computed tomography angiography (CTA)-based method for on-site evaluation of patients with suspected obstructive coronary artery disease (CAD). Aims: We aimed to compare the diagnostic performance of CT-QFR with myocardial perfusion scintigraphy (MPS) and cardiovascular magnetic resonance (CMR) as second-line tests in patients with suspected obstructive CAD after coronary CTA. Methods: A paired analysis of CT-QFR and MPS or CMR, with an invasive FFR-based classification as reference standard was carried out. Symptomatic patients with >50% diameter stenosis on coronary CTA were randomised to MPS or CMR and referred for invasive coronary angiography. Results: The rate of coronary CTA not feasible for CT-QFR analysis was 17%. Paired patient-level data were available for 118 patients in the MPS group and 113 in the CMR group. Patient-level diagnostic accuracy was better for CT-QFR than for both MPS (82.2% [95% CI: 75.2-89.2] vs 70.3% [95% CI: 62.0-78.7], p=0.029) and CMR (77.0% [95% CI: 69.1-84.9] vs 65.5% [95% CI: 56.6-74.4], p=0.047). Following a positive coronary CTA and with the intention to diagnose, CT-QFR, CMR and MPS were equally suitable as rule-in and rule-out modalities. Conclusions: The diagnostic performance of CT-QFR as a second-line test was at least similar to MPS and CMR for the evaluation of obstructive CAD in symptomatic patients presenting with ≥50% diameter stenosis on coronary CTA.