Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in ischemia-causing coronary stenosis: a meta-analysis

Purpose Fractional flow reserve based on coronary computed tomographic angiography (CCTA; FFR CT ) can evaluate functional severity in coronary artery disease (CAD). This study investigated the diagnostic value of FFR CT for determining CAD severity. Materials and methods Medline, Cochrane, EMBASE, and Google Scholar databases were searched until June 16, 2016 using the following search terms: fractional flow reserve, coronary computed tomography angiography, myocardial ischemia. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in the analysis. Results Twenty-one studies were included with a total of 2216 subjects and 2798 vessels. FFR CT , sensitivity per-vessel and per-patient were ≥82% and specificity was ≥73% for diagnosis of ischemia. FFR CT had better diagnostic accuracy and discrimination than CCTA. Conclusion This study indicates that FFR CT may be a good tool for screening and diagnosing of myocardial ischemia in patients with CAD.