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

Ashritha Penagaluri; Angela Y Higgins; Andrea L Vavere; Julie M Miller; Armin Arbab-Zadeh; Aisha Betoko; Chloe Steveson; Elke Zimmermann; Christopher Cox; Carlos E Rochitte; Marc Dewey; Klaus F Kofoed; Hiroyuki Niinuma; Marcelo F Di Carli; João A C Lima; Marcus Y Chen

doi:10.1161/CIRCIMAGING.116.005189

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

Ashritha Penagaluri, Angela Y Higgins, Andrea L Vavere, Julie M Miller, Armin Arbab-Zadeh, Aisha Betoko, Chloe Steveson, Elke Zimmermann, Christopher Cox, Carlos E Rochitte, Marc Dewey, Klaus F Kofoed, Hiroyuki Niinuma, Marcelo F Di Carli, João A C Lima, Marcus Y Chen

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16 Citationer (Scopus)

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.

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).

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.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.

Originalsprog	Engelsk
Tidsskrift	Circulation: Cardiovascular Imaging
Vol/bind	9
Udgave nummer	11
Sider (fra-til)	e005189
ISSN	1941-9651
DOI	https://doi.org/10.1161/CIRCIMAGING.116.005189
Status	Udgivet - nov. 2016

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Penagaluri, A., Higgins, A. Y., Vavere, A. L., Miller, J. M., Arbab-Zadeh, A., Betoko, A., Steveson, C., Zimmermann, E., Cox, C., Rochitte, C. E., Dewey, M., Kofoed, K. F., Niinuma, H., Di Carli, M. F., Lima, J. A. C., & Chen, M. Y. (2016). 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. Circulation: Cardiovascular Imaging, 9(11), e005189. https://doi.org/10.1161/CIRCIMAGING.116.005189

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. / Penagaluri, Ashritha; Higgins, Angela Y; Vavere, Andrea L et al.
I: Circulation: Cardiovascular Imaging, Bind 9, Nr. 11, 11.2016, s. e005189.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Penagaluri, A, Higgins, AY, Vavere, AL, Miller, JM, Arbab-Zadeh, A, Betoko, A, Steveson, C, Zimmermann, E, Cox, C, Rochitte, CE, Dewey, M, Kofoed, KF, Niinuma, H, Di Carli, MF, Lima, JAC & Chen, MY 2016, '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', Circulation: Cardiovascular Imaging, bind 9, nr. 11, s. e005189. https://doi.org/10.1161/CIRCIMAGING.116.005189

Penagaluri A, Higgins AY, Vavere AL, Miller JM, Arbab-Zadeh A, Betoko A et al. 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. Circulation: Cardiovascular Imaging. 2016 nov.;9(11):e005189. doi: 10.1161/CIRCIMAGING.116.005189

Penagaluri, Ashritha ; Higgins, Angela Y ; Vavere, Andrea L et al. / 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. I: Circulation: Cardiovascular Imaging. 2016 ; Bind 9, Nr. 11. s. e005189.

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title = "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",

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.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).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.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.",

author = "Ashritha Penagaluri and Higgins, \{Angela Y\} and Vavere, \{Andrea L\} and Miller, \{Julie M\} and Armin Arbab-Zadeh and Aisha Betoko and Chloe Steveson and Elke Zimmermann and Christopher Cox and Rochitte, \{Carlos E\} and Marc Dewey and Kofoed, \{Klaus F\} and Hiroyuki Niinuma and \{Di Carli\}, \{Marcelo F\} and Lima, \{Jo{\~a}o A C\} and Chen, \{Marcus Y\}",

note = "{\textcopyright} 2016 American Heart Association, Inc.",

year = "2016",

month = nov,

doi = "10.1161/CIRCIMAGING.116.005189",

language = "English",

volume = "9",

pages = "e005189",

journal = "Circulation: Cardiovascular Imaging",

issn = "1941-9651",

publisher = "Lippincott Williams and Wilkins",

number = "11",

}

TY - JOUR

T1 - Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women

T2 - Analysis of the CORE320 Trial (Coronary Artery Evaluation Using 320-Row Multidetector Computed Tomography Angiography and Myocardial Perfusion) According to Gender

AU - Penagaluri, Ashritha

AU - Higgins, Angela Y

AU - Vavere, Andrea L

AU - Miller, Julie M

AU - Arbab-Zadeh, Armin

AU - Betoko, Aisha

AU - Steveson, Chloe

AU - Zimmermann, Elke

AU - Cox, Christopher

AU - Rochitte, Carlos E

AU - Dewey, Marc

AU - Kofoed, Klaus F

AU - Niinuma, Hiroyuki

AU - Di Carli, Marcelo F

AU - Lima, João A C

AU - Chen, Marcus Y

PY - 2016/11

Y1 - 2016/11

N2 - 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.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).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.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.

AB - 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.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).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.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.

UR - https://www.scopus.com/pages/publications/84995751243

U2 - 10.1161/CIRCIMAGING.116.005189

DO - 10.1161/CIRCIMAGING.116.005189

M3 - Journal article

C2 - 27811151

SN - 1941-9651

VL - 9

SP - e005189

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

IS - 11

ER -