Meta-Analysis of Fractional Flow Reserve Versus Quantitative Coronary Angiography and Noninvasive Imaging for Evaluation of Myocardial Ischemia
We performed a meta-analysis of 31 studies comparing the results of fractional flow reserve (FFR) against quantitative coronary angiography (QCA) and/or noninvasive imaging of the same lesions. Studies were retrieved from PubMed (last search February 2006). Across 18 studies (1,522 lesions), QCA had...
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| Veröffentlicht in: | The American journal of cardiology 2007-02, Vol.99 (4), p.450-456 |
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| container_title | The American journal of cardiology |
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| creator | Christou, Maria A.C Siontis, George C.M Katritsis, Demosthenes G., MD, PhD Ioannidis, John P.A., MD |
| description | We performed a meta-analysis of 31 studies comparing the results of fractional flow reserve (FFR) against quantitative coronary angiography (QCA) and/or noninvasive imaging of the same lesions. Studies were retrieved from PubMed (last search February 2006). Across 18 studies (1,522 lesions), QCA had a random effects sensitivity of 78% (95% confidence interval [CI] 67 to 86) and specificity of 51% (95% CI 40 to 61) against FFR (0.75 cutoff). Overall concordances were 61% for lesions with diameter stenosis 30% to 70%, 67% for stenoses >70%, and 95% for stenoses |
| doi_str_mv | 10.1016/j.amjcard.2006.09.092 |
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Studies were retrieved from PubMed (last search February 2006). Across 18 studies (1,522 lesions), QCA had a random effects sensitivity of 78% (95% confidence interval [CI] 67 to 86) and specificity of 51% (95% CI 40 to 61) against FFR (0.75 cutoff). Overall concordances were 61% for lesions with diameter stenosis 30% to 70%, 67% for stenoses >70%, and 95% for stenoses <30%. Compared with noninvasive imaging (21 studies, 1,249 lesions), FFR had a sensitivity of 76% (95% CI 69 to 82) and specificity of 76% (95% CI 71 to 81) by random effects. Summary receiver-operator characteristic estimates were similar. Most data addressed comparisons with perfusion scintigraphy (976 lesions, sensitivity 75%, specificity 77%), and some data were also available for dobutamine stress echocardiography (273 lesions, sensitivity 82%, specificity 74%). In conclusion, QCA does not predict the functional significance of coronary lesions. FFR shows modest concordance with noninvasive imaging tests. The prognostic implications of discordant FFR and imaging results need further study.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2006.09.092</identifier><identifier>PMID: 17293182</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Blood Flow Velocity ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cardiovascular system ; Coronary Angiography - methods ; Coronary Circulation ; Coronary heart disease ; Diagnostic Imaging ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical imaging ; Medical sciences ; Meta-analysis ; Myocardial Ischemia - diagnostic imaging ; Myocarditis. Cardiomyopathies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; ROC Curve ; Sensitivity and Specificity</subject><ispartof>The American journal of cardiology, 2007-02, Vol.99 (4), p.450-456</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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Studies were retrieved from PubMed (last search February 2006). Across 18 studies (1,522 lesions), QCA had a random effects sensitivity of 78% (95% confidence interval [CI] 67 to 86) and specificity of 51% (95% CI 40 to 61) against FFR (0.75 cutoff). Overall concordances were 61% for lesions with diameter stenosis 30% to 70%, 67% for stenoses >70%, and 95% for stenoses <30%. Compared with noninvasive imaging (21 studies, 1,249 lesions), FFR had a sensitivity of 76% (95% CI 69 to 82) and specificity of 76% (95% CI 71 to 81) by random effects. Summary receiver-operator characteristic estimates were similar. Most data addressed comparisons with perfusion scintigraphy (976 lesions, sensitivity 75%, specificity 77%), and some data were also available for dobutamine stress echocardiography (273 lesions, sensitivity 82%, specificity 74%). In conclusion, QCA does not predict the functional significance of coronary lesions. FFR shows modest concordance with noninvasive imaging tests. The prognostic implications of discordant FFR and imaging results need further study.</description><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Circulation</subject><subject>Coronary heart disease</subject><subject>Diagnostic Imaging</subject><subject>Heart</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Meta-analysis</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFktuO0zAQhiMEYsvCI4AsJLhL8SFx4htQVW2h0i6I4601tSddlyQudlLUp-CVcdSKlfYGeSTLo2_-8Ryy7Dmjc0aZfLObQ7czEOycUyrnVCXjD7IZqyuVM8XEw2xGKeW5YoW6yJ7EuEtPxkr5OLtgFVeC1XyW_bnBAfJFD-0xukh8Q1YBzOB88pBV63-TLxgxHJD8wBDHSD6P0A9ugMEl39KHBIYjWfRb57cB9rdHAr0lH33v-gPECVp3sHX9ljQ-kKsDtCNM8lOqm6OfKnAp1TqaW-wcPM0eNdBGfHa-L7Pvq6tvyw_59af36-XiOjdlwYac4caKjVIba2tbQ2OV5dRUCnlRbFDIsrJMSjCiKKoSLAdLZSMqg3XZNNQqcZm9Punug_81Yhx056LBtoUe_Ri1rFU6tErgy3vgzo8hdSdqLqiQqmCTWnmCTPAxBmz0PrguNUYzqqdx6Z0-j0tP49JUJeMp7sVZfNx0aO-izvNJwKszANFA2wTojYt3XK0Y51Ik7t2Jw9Szg8Ogo3HYG7QuoBm09e6_X3l7T8G0rncp6U88YvxXNNORa6q_Trs1rRaVlLNCSPEXi3fNbw</recordid><startdate>20070215</startdate><enddate>20070215</enddate><creator>Christou, Maria A.C</creator><creator>Siontis, George C.M</creator><creator>Katritsis, Demosthenes G., MD, PhD</creator><creator>Ioannidis, John P.A., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20070215</creationdate><title>Meta-Analysis of Fractional Flow Reserve Versus Quantitative Coronary Angiography and Noninvasive Imaging for Evaluation of Myocardial Ischemia</title><author>Christou, Maria A.C ; Siontis, George C.M ; Katritsis, Demosthenes G., MD, PhD ; Ioannidis, John P.A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-1ebd3b99bdd8d8afd9d20c79e244be3657d166ac34475ad2ad06f37ce85ff0d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular system</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Circulation</topic><topic>Coronary heart disease</topic><topic>Diagnostic Imaging</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Meta-analysis</topic><topic>Myocardial Ischemia - diagnostic imaging</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Christou, Maria A.C</creatorcontrib><creatorcontrib>Siontis, George C.M</creatorcontrib><creatorcontrib>Katritsis, Demosthenes G., MD, PhD</creatorcontrib><creatorcontrib>Ioannidis, John P.A., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Christou, Maria A.C</au><au>Siontis, George C.M</au><au>Katritsis, Demosthenes G., MD, PhD</au><au>Ioannidis, John P.A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-Analysis of Fractional Flow Reserve Versus Quantitative Coronary Angiography and Noninvasive Imaging for Evaluation of Myocardial Ischemia</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-02-15</date><risdate>2007</risdate><volume>99</volume><issue>4</issue><spage>450</spage><epage>456</epage><pages>450-456</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>We performed a meta-analysis of 31 studies comparing the results of fractional flow reserve (FFR) against quantitative coronary angiography (QCA) and/or noninvasive imaging of the same lesions. Studies were retrieved from PubMed (last search February 2006). Across 18 studies (1,522 lesions), QCA had a random effects sensitivity of 78% (95% confidence interval [CI] 67 to 86) and specificity of 51% (95% CI 40 to 61) against FFR (0.75 cutoff). Overall concordances were 61% for lesions with diameter stenosis 30% to 70%, 67% for stenoses >70%, and 95% for stenoses <30%. Compared with noninvasive imaging (21 studies, 1,249 lesions), FFR had a sensitivity of 76% (95% CI 69 to 82) and specificity of 76% (95% CI 71 to 81) by random effects. Summary receiver-operator characteristic estimates were similar. Most data addressed comparisons with perfusion scintigraphy (976 lesions, sensitivity 75%, specificity 77%), and some data were also available for dobutamine stress echocardiography (273 lesions, sensitivity 82%, specificity 74%). In conclusion, QCA does not predict the functional significance of coronary lesions. FFR shows modest concordance with noninvasive imaging tests. The prognostic implications of discordant FFR and imaging results need further study.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17293182</pmid><doi>10.1016/j.amjcard.2006.09.092</doi><tpages>7</tpages></addata></record> |
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| subjects | Biological and medical sciences Blood Flow Velocity Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Coronary Angiography - methods Coronary Circulation Coronary heart disease Diagnostic Imaging Heart Humans Investigative techniques, diagnostic techniques (general aspects) Medical imaging Medical sciences Meta-analysis Myocardial Ischemia - diagnostic imaging Myocarditis. Cardiomyopathies Radiodiagnosis. Nmr imagery. Nmr spectrometry ROC Curve Sensitivity and Specificity |
| title | Meta-Analysis of Fractional Flow Reserve Versus Quantitative Coronary Angiography and Noninvasive Imaging for Evaluation of Myocardial Ischemia |
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