Prognostic value of noninvasive combined anatomic/functional assessment by cardiac CT in patients with suspected coronary artery disease - Comparison with invasive coronary angiography and nuclear myocardial perfusion imaging for the five-year-follow up of the CORE320 multicenter study

被引：10

作者：

Dewey, Marc ^{[1
]}

Rochitte, Carlos E. ^{[2
]}

Ostovaneh, Mohammad R. ^{[3
]}

Chen, Marcus Y. ^{[4
]}

George, Richard T. ^{[3
]}

Niinuma, Hiroyuki ^{[5
,6
]}

Kitagawa, Kakuya ^{[7
]}

Laham, Roger ^{[8
]}

Kofoed, Klaus ^{[9
]}

Nomura, Cesar ^{[12
]}

Sakuma, Hajime ^{[7
]}

Yoshioka, Kunihiro ^{[5
]}

Mehra, Vishal C. ^{[3
]}

Jinzaki, Masahiro ^{[14
]}

Kuribayashi, Sachio ^{[14
]}

Laule, Michael ^{[10
]}

Paul, Narinder ^{[11
]}

Scholte, Arthur J. ^{[13
]}

Cerci, Rodrigo ^{[3
]}

Hoe, John ^{[16
]}

Tan, Swee Yaw ^{[15
]}

Rybicki, Frank J. ^{[17
]}

Matheson, Matthew B. ^{[18
]}

Vavere, Andrea L. ^{[3
]}

Arai, Andrew E. ^{[4
]}

Miller, Julie M. ^{[3
]}

Cox, Christopher ^{[18
]}

Brinker, Jeffrey ^{[3
]}

Clouse, Melvin E. ^{[8
]}

Di Carli, Marcelo ^{[19
]}

Lima, Joao A. C. ^{[3
]}

Arbab-Zadeh, Armin ^{[3
]}

机构：

[1] Charite Med Sch Humboldt, Dept Radiol, Berlin, Germany

[2] Univ Sao Paulo, InCor Heart Inst, Med Sch, Sao Paulo, Brazil

[3] Johns Hopkins Hosp & Sch Med, 600 N Wolfe St,Blalock 524, Baltimore, MD 21287 USA

[4] NHLBI, Cardiol Branch, NIH, Bldg 10, Bethesda, MD 20892 USA

[5] Iwate Med Univ, Mem Heart Ctr, Morioka, Iwate, Japan

[6] St Lukes Int Hosp, Dept Radiol, Tokyo, Japan

[7] Mie Univ Hosp, Dept Radiol, Tsu, Mie, Japan

[8] Harvard Univ, Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA

[9] Univ Copenhagen, Rigs Hosp, Dept Cardiol, Copenhagen, Denmark

[10] Charite Med Sch Hwnboldt, Dept Med Cardiol, Berlin, Germany

[11] Toronto Gen Hosp, Dept Med Imaging, Toronto, ON, Canada

[12] Hosp Israelita Albert Einstein, Radiol Sect, Sao Paulo, Brazil

[13] Leiden Univ, Dept Cardiol, Med Ctr, Leiden, Netherlands

[14] Keio Univ, Sch Med, Tokyo, Japan

[15] Natl Heart Ctr, Dept Cardiol, Singapore, Singapore

[16] Mt Elizabeth Hosp, CT Ctr, Medi Rad Associates, Singapore, Singapore

[17] Univ Cincinnati, Dept Radiol, Cincinnati, OH USA

[18] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[19] Brigham & Womens Hosp, Dept Nucl Med & Cardiovasc Imaging, 75 Francis St, Boston, MA 02115 USA

来源：

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY | 2021年 / 15卷 / 06期

基金：

美国国家卫生研究院;

关键词：

Coronary heart disease; Coronary artery disease; Coronary atherosclerosis; Coronary imaging; CT angiography; Myocardial perfusion imaging; COMPUTED-TOMOGRAPHY; DIAGNOSTIC PERFORMANCE; ATHEROSCLEROSIS; STENOSIS; DESIGN;

D O I：

10.1016/j.jcct.2021.04.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Few data exist on long-term outcome in patients undergoing combined coronary CT angiography (CTA) and myocardial CT perfusion imaging (CTP) as well as invasive coronary angiography (ICA) and single photon emission tomography (SPECT). Methods: At 16 centers, 381 patients were followed for major adverse cardiac events (MACE) for the CORE320 study. All patients underwent coronary CTA, CTP, and SPECT before ICA within 60 days. Prognostic performance according binary results (normal/abnormal) was assessed by 5-year major cardiovascular events (MACE) free survival and area under the receiver-operating-characteristic curve (AUC). Results: Follow up beyond 2-years was available in 323 patients. MACE-free survival rate was greater among patients with normal combined CTA-CTP findings compared to ICA-SPECT: 85 vs. 80% (95% confidence interval [CI] for difference 0.1, 11.3) though event-free survival time was similar (4.54 vs. 4.37 years, 95% CI for dif-ference:-0.03, 0.36). Abnormal results by combined CTA-CTP was associated with 3.83 years event-free survival vs. 3.66 years after abnormal combined ICA-SPECT (95% CI for difference:-0.05, 0.39). Predicting MACE by AUC also was similar: 65 vs. 65 (difference 0.1; 95% CI-4.6, 4.9). When MACE was restricted to cardiovascular death, myocardial infarction, or stroke, AUC for CTA-CTP was 71 vs. 60 by ICA-SPECT (difference 11.2; 95% CI-1.0, 19.7). Conclusions: Combined CTA-CTP evaluation yields at least equal 5-year prognostic information as combined ICA-SPECT assessment in patients presenting with suspected coronary artery disease. Noninvasive cardiac CT assessment may eliminate the need for diagnostic cardiac catheterization in many patients. Clinical trial registration:NCT00934037.

引用

页码：485 / 491

页数：7

共 50 条

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