Non-invasive computed fractional flow reserve from computed tomography (Ct) for diagnosing coronary artery disease; japanese results from nxt trial (analysis of coronary blood flow using ct angiography: Next steps)

Toru Miyoshi, Kazuhiro Osawa, Hiroshi Ito, Susumu Kanazawa, Takeshi Kimura, Hiroki Shiomi, Sachio Kuribayashi, Masahiro Jinzaki, Akio Kawamura, Hiram Bezerra, Hiram Bezerra, Bjarne L. Nørgaard

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Recently, a non-invasive method using computational fluid dynamics to calculate vessel-specific fractional flow reserve (FFRct) from routinely acquired coronary computed tomography angiography (CTA) was described. The Analysis of Coronary Blood Flow Using CT Angiography: Next Steps (NXT) trial, which was a prospective, multicenter trial including 254 patients with suspected coronary artery disease, noted high diagnostic performance of FFRct compared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRct vs. standard stenosis quantification on coronary CTA in the Japanese subset of the NXT trial.

Conclusions: FFRct has high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial.

Methods and Results: A total of 57 Japanese participants were included from Okayama University (n=36), Kyoto University (n=17), and Keio University (n=4) Hospitals. Per-patient diagnostic accuracy of FFRct (74%; 95% confidence interval [CI]: 60–85%) was higher than for coronary CTA (47%; 95% CI: 34–61%, P<0.001) arising from improved specificity (63% vs. 27%, P<0.001). FFRct correctly reclassified 53% of patients and 63% of vessels with coronary CTA false positives as true negatives. When patients with Agatston score >1,000 were excluded, per-pa-tient accuracy of FFRct was 83% with a high specificity of 76%, similar to the overall NXT trial findings.

Original languageEnglish
Pages (from-to)406-412
Number of pages7
JournalCirculation Journal
Volume79
Issue number2
DOIs
Publication statusPublished - 2015 Jan 16

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Coronary Artery Disease
Angiography
Tomography
Confidence Intervals
Hydrodynamics
Multicenter Studies
Pathologic Constriction
Computed Tomography Angiography

Keywords

  • Computed tomography
  • Coronary artery disease
  • Fractional flow reserve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Non-invasive computed fractional flow reserve from computed tomography (Ct) for diagnosing coronary artery disease; japanese results from nxt trial (analysis of coronary blood flow using ct angiography : Next steps). / Miyoshi, Toru; Osawa, Kazuhiro; Ito, Hiroshi; Kanazawa, Susumu; Kimura, Takeshi; Shiomi, Hiroki; Kuribayashi, Sachio; Jinzaki, Masahiro; Kawamura, Akio; Bezerra, Hiram; Bezerra, Hiram; Nørgaard, Bjarne L.

In: Circulation Journal, Vol. 79, No. 2, 16.01.2015, p. 406-412.

Research output: Contribution to journalArticle

Miyoshi, Toru ; Osawa, Kazuhiro ; Ito, Hiroshi ; Kanazawa, Susumu ; Kimura, Takeshi ; Shiomi, Hiroki ; Kuribayashi, Sachio ; Jinzaki, Masahiro ; Kawamura, Akio ; Bezerra, Hiram ; Bezerra, Hiram ; Nørgaard, Bjarne L. / Non-invasive computed fractional flow reserve from computed tomography (Ct) for diagnosing coronary artery disease; japanese results from nxt trial (analysis of coronary blood flow using ct angiography : Next steps). In: Circulation Journal. 2015 ; Vol. 79, No. 2. pp. 406-412.
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AU - Miyoshi, Toru

AU - Osawa, Kazuhiro

AU - Ito, Hiroshi

AU - Kanazawa, Susumu

AU - Kimura, Takeshi

AU - Shiomi, Hiroki

AU - Kuribayashi, Sachio

AU - Jinzaki, Masahiro

AU - Kawamura, Akio

AU - Bezerra, Hiram

AU - Bezerra, Hiram

AU - Nørgaard, Bjarne L.

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N2 - Background: Recently, a non-invasive method using computational fluid dynamics to calculate vessel-specific fractional flow reserve (FFRct) from routinely acquired coronary computed tomography angiography (CTA) was described. The Analysis of Coronary Blood Flow Using CT Angiography: Next Steps (NXT) trial, which was a prospective, multicenter trial including 254 patients with suspected coronary artery disease, noted high diagnostic performance of FFRct compared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRct vs. standard stenosis quantification on coronary CTA in the Japanese subset of the NXT trial.Conclusions: FFRct has high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial.Methods and Results: A total of 57 Japanese participants were included from Okayama University (n=36), Kyoto University (n=17), and Keio University (n=4) Hospitals. Per-patient diagnostic accuracy of FFRct (74%; 95% confidence interval [CI]: 60–85%) was higher than for coronary CTA (47%; 95% CI: 34–61%, P<0.001) arising from improved specificity (63% vs. 27%, P<0.001). FFRct correctly reclassified 53% of patients and 63% of vessels with coronary CTA false positives as true negatives. When patients with Agatston score >1,000 were excluded, per-pa-tient accuracy of FFRct was 83% with a high specificity of 76%, similar to the overall NXT trial findings.

AB - Background: Recently, a non-invasive method using computational fluid dynamics to calculate vessel-specific fractional flow reserve (FFRct) from routinely acquired coronary computed tomography angiography (CTA) was described. The Analysis of Coronary Blood Flow Using CT Angiography: Next Steps (NXT) trial, which was a prospective, multicenter trial including 254 patients with suspected coronary artery disease, noted high diagnostic performance of FFRct compared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRct vs. standard stenosis quantification on coronary CTA in the Japanese subset of the NXT trial.Conclusions: FFRct has high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial.Methods and Results: A total of 57 Japanese participants were included from Okayama University (n=36), Kyoto University (n=17), and Keio University (n=4) Hospitals. Per-patient diagnostic accuracy of FFRct (74%; 95% confidence interval [CI]: 60–85%) was higher than for coronary CTA (47%; 95% CI: 34–61%, P<0.001) arising from improved specificity (63% vs. 27%, P<0.001). FFRct correctly reclassified 53% of patients and 63% of vessels with coronary CTA false positives as true negatives. When patients with Agatston score >1,000 were excluded, per-pa-tient accuracy of FFRct was 83% with a high specificity of 76%, similar to the overall NXT trial findings.

KW - Computed tomography

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