A meta-analysis comparing the diagnostic performance of computed tomography-derived fractional flow reserve and coronary computed tomography angiography at different levels of coronary artery calcium score.
Eur Radiol
; 34(9): 5621-5632, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38334761
ABSTRACT
OBJECTIVES:
The impact of coronary calcification on the diagnostic accuracy of computed tomography-derived fractional flow reserve (CT-FFR) and coronary computed tomography angiography (CCTA) remains a crucial consideration. This meta-analysis aims to compare the diagnostic performance of CT-FFR and CCTA at different levels of coronary artery calcium score (CACS). METHODS ANDRESULTS:
We searched PubMed, Embase, and the Cochrane Library for relevant articles on CCTA, CT-FFR, and invasive fractional flow reserve (FFR). Ten studies were included to evaluate the diagnostic performance of CT-FFR and CCTA at the per-patient and per-vessel levels in four CACS groups. Invasive FFR was used as the reference standard. Except for the CACS ≥ 400 group, the AUC of CT-FFR was higher than those of CCTA in other subgroups of CACS (in CACS < 100 (per-patient, 0.9 (95% CI 0.87-0.92) vs. 0.32 (95% CI 0.28-0.36); per-vessel, 0.92 (95% CI 0.89-0.94) vs. 0.66 (95% CI 0.62-0.7); both p < 0.001), CACS ≥ 100 (per-patient, 0.86 (95% CI 0.82-0.88) vs. 0.44 (95% CI 0.4-0.48); per-vessel, 0.88 (95% CI 0.85-0.9) vs. 0.51 (95% CI 0.46-0.55); both p < 0.001), and CACS < 400 (per-patient, 0.9 (95% CI 0.87-0.93) vs. 0.74 (95% CI 0.7-0.78), p < 0.001; per-vessel, 0.8 (95% CI 0.76-0.83) vs. 0.74 (95% CI 0.7-0.78); p = 0.02)).CONCLUSIONS:
CT-FFR demonstrates superior diagnostic performance in low CACS groups (CACS < 400) than CCTA in detecting hemodynamic stenoses in patients with coronary artery disease (CAD). CLINICAL RELEVANCE STATEMENT Computed tomography-derived fractional flow reserve might be utilized to determine the necessity of invasive coronary angiography in coronary artery disease patients with coronary artery calcium score < 400. KEY POINTS ⢠There is a lack of meta-analysis comparing the diagnostic performance of computed tomography-derived fractional flow reserve and coronary computed tomography angiography at different levels of calcification. ⢠Computed tomography-derived fractional flow reserve only has a better diagnostic performance than coronary computed tomography angiography with low amounts of coronary calcium. ⢠For the low coronary artery calcium score group, computed tomography-derived fractional flow reserve might be a good non-invasive method to detect hemodynamic stenoses in coronary artery disease patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Angiografía Coronaria
/
Calcificación Vascular
/
Angiografía por Tomografía Computarizada
Tipo de estudio:
Diagnostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Alemania