Fractional flow reserve using computed tomography for assessing coronary artery disease

A meta-analysis

Hemang B. Panchal, Sreenivas P. Veeranki, Samit Bhatheja, Neil Barry, Ehtisham Mahmud, Matthew Budoff, Steven J. Lavine, Hadii M. Mamudu, Timir K. Paul

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: Noninvasive fractional flow reserve (FFR) measurement with computed tomography (FFRCT) is a newly described method for assessing functional significance of coronary disease. The objective of this metaanalysis is to determine the diagnostic performance of FFRCTin the assessment of hemodynamically significant coronary artery stenosis. Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched from January 2000 through February 2015. Six original studies were found comparing FFRCTto invasive FFR in evaluating hemodynamic significance of coronary lesions (1354 vessels; 812 patients). Lesions were considered hemodynamically significant if invasive FFR was 0.80 or less. FFRCTused the same cutoff as invasive FFR to be considered as a positive test. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were calculated. Results: One-third of the lesions (n=443) were hemodynamically significant. The pooled per-vessel analysis showed that the sensitivity, specificity, negative and positive likelihood ratios, and diagnostic odds ratio of FFRCTto diagnose hemodynamically significant coronary disease were 0.84 [95% confidence interval (CI):0.80-0.87], 0.76 (95% CI: 0.73-0.79), 0.22 (95% CI: 0.17-0.29), 3.48 (95% CI: 2.21-5.47), and 16.82 (95% CI: 8.20-34.49), respectively. Conclusion: The results of this meta-analysis demonstrate that FFRCTresults correlate closely with invasive coronary angiography and FFR measurement. It is a feasible noninvasive method to assess hemodynamic significance of coronary lesions in patients with stable coronary artery disease.

Original languageEnglish (US)
Pages (from-to)694-700
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume17
Issue number9
DOIs
StatePublished - 2016

Fingerprint

Meta-Analysis
Coronary Artery Disease
Tomography
Confidence Intervals
Coronary Disease
Hemodynamics
Odds Ratio
Sensitivity and Specificity
Coronary Stenosis
Coronary Angiography
PubMed

Keywords

  • Computed tomography angiography
  • Coronary artery lesion
  • Diagnostic accuracy
  • Fractional flow reserve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Panchal, H. B., Veeranki, S. P., Bhatheja, S., Barry, N., Mahmud, E., Budoff, M., ... Paul, T. K. (2016). Fractional flow reserve using computed tomography for assessing coronary artery disease: A meta-analysis. Journal of Cardiovascular Medicine, 17(9), 694-700. https://doi.org/10.2459/JCM.0000000000000415

Fractional flow reserve using computed tomography for assessing coronary artery disease : A meta-analysis. / Panchal, Hemang B.; Veeranki, Sreenivas P.; Bhatheja, Samit; Barry, Neil; Mahmud, Ehtisham; Budoff, Matthew; Lavine, Steven J.; Mamudu, Hadii M.; Paul, Timir K.

In: Journal of Cardiovascular Medicine, Vol. 17, No. 9, 2016, p. 694-700.

Research output: Contribution to journalArticle

Panchal, HB, Veeranki, SP, Bhatheja, S, Barry, N, Mahmud, E, Budoff, M, Lavine, SJ, Mamudu, HM & Paul, TK 2016, 'Fractional flow reserve using computed tomography for assessing coronary artery disease: A meta-analysis', Journal of Cardiovascular Medicine, vol. 17, no. 9, pp. 694-700. https://doi.org/10.2459/JCM.0000000000000415
Panchal, Hemang B. ; Veeranki, Sreenivas P. ; Bhatheja, Samit ; Barry, Neil ; Mahmud, Ehtisham ; Budoff, Matthew ; Lavine, Steven J. ; Mamudu, Hadii M. ; Paul, Timir K. / Fractional flow reserve using computed tomography for assessing coronary artery disease : A meta-analysis. In: Journal of Cardiovascular Medicine. 2016 ; Vol. 17, No. 9. pp. 694-700.
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abstract = "Aims: Noninvasive fractional flow reserve (FFR) measurement with computed tomography (FFRCT) is a newly described method for assessing functional significance of coronary disease. The objective of this metaanalysis is to determine the diagnostic performance of FFRCTin the assessment of hemodynamically significant coronary artery stenosis. Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched from January 2000 through February 2015. Six original studies were found comparing FFRCTto invasive FFR in evaluating hemodynamic significance of coronary lesions (1354 vessels; 812 patients). Lesions were considered hemodynamically significant if invasive FFR was 0.80 or less. FFRCTused the same cutoff as invasive FFR to be considered as a positive test. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were calculated. Results: One-third of the lesions (n=443) were hemodynamically significant. The pooled per-vessel analysis showed that the sensitivity, specificity, negative and positive likelihood ratios, and diagnostic odds ratio of FFRCTto diagnose hemodynamically significant coronary disease were 0.84 [95{\%} confidence interval (CI):0.80-0.87], 0.76 (95{\%} CI: 0.73-0.79), 0.22 (95{\%} CI: 0.17-0.29), 3.48 (95{\%} CI: 2.21-5.47), and 16.82 (95{\%} CI: 8.20-34.49), respectively. Conclusion: The results of this meta-analysis demonstrate that FFRCTresults correlate closely with invasive coronary angiography and FFR measurement. It is a feasible noninvasive method to assess hemodynamic significance of coronary lesions in patients with stable coronary artery disease.",
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AU - Barry, Neil

AU - Mahmud, Ehtisham

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AU - Lavine, Steven J.

AU - Mamudu, Hadii M.

AU - Paul, Timir K.

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AB - Aims: Noninvasive fractional flow reserve (FFR) measurement with computed tomography (FFRCT) is a newly described method for assessing functional significance of coronary disease. The objective of this metaanalysis is to determine the diagnostic performance of FFRCTin the assessment of hemodynamically significant coronary artery stenosis. Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched from January 2000 through February 2015. Six original studies were found comparing FFRCTto invasive FFR in evaluating hemodynamic significance of coronary lesions (1354 vessels; 812 patients). Lesions were considered hemodynamically significant if invasive FFR was 0.80 or less. FFRCTused the same cutoff as invasive FFR to be considered as a positive test. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were calculated. Results: One-third of the lesions (n=443) were hemodynamically significant. The pooled per-vessel analysis showed that the sensitivity, specificity, negative and positive likelihood ratios, and diagnostic odds ratio of FFRCTto diagnose hemodynamically significant coronary disease were 0.84 [95% confidence interval (CI):0.80-0.87], 0.76 (95% CI: 0.73-0.79), 0.22 (95% CI: 0.17-0.29), 3.48 (95% CI: 2.21-5.47), and 16.82 (95% CI: 8.20-34.49), respectively. Conclusion: The results of this meta-analysis demonstrate that FFRCTresults correlate closely with invasive coronary angiography and FFR measurement. It is a feasible noninvasive method to assess hemodynamic significance of coronary lesions in patients with stable coronary artery disease.

KW - Computed tomography angiography

KW - Coronary artery lesion

KW - Diagnostic accuracy

KW - Fractional flow reserve

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