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Diagnostic value of coronary CT angiography in comparison with invasive coronary angiography and intravascular ultrasound in patients with intermediate coronary artery stenosis: results from the prospective multicentre FIGURE-OUT (Functional Imaging criteria for GUiding REview of invasive coronary angiOgraphy, intravascular Ultrasound, and coronary computed Tomographic angiography) study

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Author(s)
Joon-Hyung DohBon-Kwon KooChang-Wook NamJi-Hyun KimJames K. MinRyo NakazatoTodung SilalahiHardjo PrawiraHyunmin ChoiSung Yun LeeJune NamgungSung Uk KwonJae-Jin KwakWon Ro Lee
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
European Heart Journal - Cardiovascular Imaging
Issued Date
2014
Volume
15
Issue
8
Abstract
Aims The anatomical criteria for the diagnosis of ischaemia referenced by fractional flowreserve (FFR) from non-invasive coronary
computed tomographic angiography (CCTA), invasive coronary angiography (ICA), and intravascular ultrasound
(IVUS) have not been evaluated contemporarily in a large-scale study. The aim of this study was to assess the diagnostic
value of CCTA compared with ICA and IVUS in patients with intermediate coronary stenosis.
Methods
and results
CCTA, ICA, IVUS, and FFR were performed in 181 coronary lesions with intermediate severity. Minimal lumen diameter
(MLD) and per cent diameter stenosis (%DS) were determined by CCTA and ICA, whereas minimal lumen area (MLA)
was determined by CCTA and IVUS. Inducible ischaemiawas defined by FFR ≤0.80. Diagnostic performances from noninvasive
and invasive methods were compared. FFR ≤0.80 was observed in 49 (27.1%) lesions. CCTA MLD was smaller
than ICA MLD (1.3+0.5 vs. 1.5+0.4 mm, P , 0.001), CCTA %DS was higher than ICA %DS (54.0+14.0 vs.
50.3+12.8%, P , 0.001), and CCTA MLA was smaller than IVUS MLA (2.2+1.2 vs. 3.2+1.2 mm2, P , 0.001). This
trend was consistent irrespective of lesion location, lesion severity, and plaque characteristics. For the determination
of ischaemia, diagnostic performance of CCTA %DS was lower than ICA %DS [area under the curve (AUC) 0.657 vs.
0.765, P ¼ 0.04], and that of CCTA MLA was lower than IVUS MLA (AUC 0.712 vs. 0.801, P ¼ 0.03).
Conclusion Anatomical criteria for the diagnosis of ischaemia-producing coronary stenosis differ by non-invasive and invasive
methods. Compared with invasive methods, CCTA presents overestimation in assessing lesion severity and lower diagnostic
performance in assessing ischaemia.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine
Citation
Joon-Hyung Doh et al. (2014). Diagnostic value of coronary CT angiography
in comparison with invasive coronary angiography
and intravascular ultrasound in patients with
intermediate coronary artery stenosis: results
from the prospective multicentre FIGURE-OUT
(Functional Imaging criteria for GUiding REview
of invasive coronary angiOgraphy, intravascular
Ultrasound, and coronary computed
Tomographic angiography) study. European Heart Journal - Cardiovascular Imaging, 15(8), 870–877. doi: 10.1093/ehjci/jeu009
Type
Article
ISSN
2047-2404
DOI
10.1093/ehjci/jeu009
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35650
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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