Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women: Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender
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Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women : Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender. / Penagaluri, Ashritha; Higgins, Angela Y.; Vavere, Andrea L; Miller, Julie M; Arbab-Zadeh, Armin; Betoko, Aisha; Steveson, Chloe; Zimmermann, Elke; Cox, Christopher; Rochitte, Carlos E; Dewey, Marc; Kofoed, Klaus F.; Niinuma, Hiroyuki; Di Carli, Marcelo F; Lima, Joao A C; Chen, Marcus Y.
I: Circulation: Cardiovascular Imaging, Bind 9, Nr. 11, e005189, 2016.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women
T2 - Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender
AU - Penagaluri, Ashritha
AU - Higgins, Angela Y.
AU - Vavere, Andrea L
AU - Miller, Julie M
AU - Arbab-Zadeh, Armin
AU - Betoko, Aisha
AU - Steveson, Chloe
AU - Zimmermann, Elke
AU - Cox, Christopher
AU - Rochitte, Carlos E
AU - Dewey, Marc
AU - Kofoed, Klaus F.
AU - Niinuma, Hiroyuki
AU - Di Carli, Marcelo F
AU - Lima, Joao A C
AU - Chen, Marcus Y
PY - 2016
Y1 - 2016
N2 - Background-Coronary computed tomographic angiography (CTA) and myocardial perfusion imaging (CTP) is a validated approach for detection and exclusion of flow-limiting coronary artery disease (CAD), but little data are available on gender-specific performance of these modalities. In this study, we aimed to evaluate the diagnostic accuracy of combined coronary CTA and CTP in detecting flow-limiting CAD in women compared with men. Methods and Results-Three hundred and eighty-one patients who underwent both CTA-CTP and single-photon emission computed tomography myocardial perfusion imaging preceding invasive coronary angiography as part of the CORE320 multicenter study (Coronary Artery Evaluation Using 320-row Multidetector Computed Tomography Angiography and Myocardial Perfusion) were included in this ancillary study. All 4 image modalities were analyzed in blinded, independent core laboratories. Prevalence of flow-limiting CAD defined by invasive coronary angiography equal to 50% or greater with an associated single-photon emission computed tomography myocardial perfusion imaging defect was 45% (114/252) and 23% (30/129) in males and females, respectively. Patient-based diagnostic accuracy defined by the area under the receiver operating curve for detecting flow-limiting CAD by CTA alone in females was 0.83 (0.75-0.89) and for CTA-CTP was 0.92 (0.86-0.97; P=0.003) compared with men where the area under the receiver operating curve for detecting flow-limiting CAD by CTA alone was 0.82 (0.77-0.87) and for CTA-CTP was 0.84 (0.80-0.89; P=0.29). Conclusions-The combination of CTA-CTP was performed similarly in men and women for identifying flow-limiting coronary stenosis; however, in women, CTP had incremental value over CTA alone, which was not the case in men.
AB - Background-Coronary computed tomographic angiography (CTA) and myocardial perfusion imaging (CTP) is a validated approach for detection and exclusion of flow-limiting coronary artery disease (CAD), but little data are available on gender-specific performance of these modalities. In this study, we aimed to evaluate the diagnostic accuracy of combined coronary CTA and CTP in detecting flow-limiting CAD in women compared with men. Methods and Results-Three hundred and eighty-one patients who underwent both CTA-CTP and single-photon emission computed tomography myocardial perfusion imaging preceding invasive coronary angiography as part of the CORE320 multicenter study (Coronary Artery Evaluation Using 320-row Multidetector Computed Tomography Angiography and Myocardial Perfusion) were included in this ancillary study. All 4 image modalities were analyzed in blinded, independent core laboratories. Prevalence of flow-limiting CAD defined by invasive coronary angiography equal to 50% or greater with an associated single-photon emission computed tomography myocardial perfusion imaging defect was 45% (114/252) and 23% (30/129) in males and females, respectively. Patient-based diagnostic accuracy defined by the area under the receiver operating curve for detecting flow-limiting CAD by CTA alone in females was 0.83 (0.75-0.89) and for CTA-CTP was 0.92 (0.86-0.97; P=0.003) compared with men where the area under the receiver operating curve for detecting flow-limiting CAD by CTA alone was 0.82 (0.77-0.87) and for CTA-CTP was 0.84 (0.80-0.89; P=0.29). Conclusions-The combination of CTA-CTP was performed similarly in men and women for identifying flow-limiting coronary stenosis; however, in women, CTP had incremental value over CTA alone, which was not the case in men.
KW - Computed tomography
KW - coronary angiography
KW - gender
KW - myocardial perfusion imaging
KW - women
U2 - 10.1161/CIRCIMAGING.116.005189
DO - 10.1161/CIRCIMAGING.116.005189
M3 - Journal article
C2 - 27811151
AN - SCOPUS:84995751243
VL - 9
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
SN - 1941-9651
IS - 11
M1 - e005189
ER -
ID: 179043379