Abstract 15769: Diagnostic Performance of the Combined Coronary Computed Tomographic Angiography Parameters and Invasive Coronary Angiography/Intravascular Ultrasound Parameters on the Diagnosis of Ischemia for Intermediate Coronary Stenoses: Results From the Prospective Multicenter FIGURE-OUT Study
Background: The aim of this study was to evaluate diagnostic performance of the combined non-invasive and invasive anatomic criteria for the diagnosis of ischemia for lesions of intermediate stenosis severity.
Methods: CCTA, ICA, IVUS and FFR were performed to evaluate 181 lesions of intermediate stenosis severity. Percent diameter stenosis (%DS) was determined by CCTA and quantitative coronary angiography (QCA), while minimal lumen area (MLA) was determined by CCTA and IVUS. FFR <0.80 was considered diagnosis of lesion-specific ischemia.Integration of CCTA and IVUS parameters was calculated as probability by logistic regression analysis. The area under the curve (AUC) by the receiver operating characteristics (ROC) curve analysis was calculated to examine the diagnostic performance of CCTA, ICA and IVUS parameters to define the presence of myocardial ischemia
Results: Ischemia was defined by FFR <0.80 and was observed in 49 lesions (27.1%). CCTA %DS was higher than ICA %DS (54.0±14.0 vs. 50.3±12.8%, p<0.001), while CCTA MLA was smaller than IVUS MLA (2.2±1.2 vs. 3.2±1.2mm2, p<0.001). For the determination of ischemia-causing lesions, diagnostic performance of CCTA %DS was lower than ICA %DS (AUC 0.657 vs. 0.765, p=0.04), and that of CCTA MLA was lower than IVUS MLA (AUC 0.712 vs. 0.801, p=0.03). Diagnostic performance of combined CCTA %DS, MLD and MLA was higher than CCTA %DS alone (AUC 0.733 vs. 0.657, p=0.04). The performance of combined CCTA %DS and MLA was comparable to ICA %DS (AUC 0.719 vs. 0.765, p=0.32), and combined CCTA MLA and ICA %DS comparable to IVUS MLA (AUC 0.785 vs. 0.801, p=0.71).
Conclusions: CCTA overestimated lesion severity and its performance for the diagnosis of ischemia was lower compared to invasive methods. Imaging criteria derived from quantitative CCTA measurement including MLA and their combination could offer better functional diagnostic methods.
- © 2013 by American Heart Association, Inc.