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

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

来源：Circulation-Cardiovascular Imaging, 2016, 9(11): e005189.

DOI：10.1161/CIRCIMAGING.116.005189

• computed tomography
• coronary angiography
• gender
• myocardial perfusion imaging
• women

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.

• 出版日期2016-11
• 单位NIH