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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.
- Source :
-
Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2016 Nov; Vol. 9 (11). - Publication Year :
- 2016
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Abstract
- 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.<br />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).<br />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.<br />Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.<br /> (© 2016 American Heart Association, Inc.)
- Subjects :
- Aged
Area Under Curve
Coronary Artery Disease physiopathology
Coronary Stenosis physiopathology
Coronary Vessels physiopathology
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
ROC Curve
Reproducibility of Results
Severity of Illness Index
Sex Factors
Computed Tomography Angiography
Coronary Angiography methods
Coronary Artery Disease diagnostic imaging
Coronary Circulation
Coronary Stenosis diagnostic imaging
Coronary Vessels diagnostic imaging
Multidetector Computed Tomography
Myocardial Perfusion Imaging methods
Tomography, Emission-Computed, Single-Photon
Subjects
Details
- Language :
- English
- ISSN :
- 1942-0080
- Volume :
- 9
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 27811151
- Full Text :
- https://doi.org/10.1161/CIRCIMAGING.116.005189