Diagnostic performance of non-invasive imaging for stable coronary artery disease: A meta-analysis
Diagnostic performance of non-invasive imaging for stable coronary artery disease: A meta-analysis
复制标题
非侵入性成像对稳定型冠状动脉疾病诊断性能的荟萃分析
DOI：
10.1016/j.ijcard.2019.10.046
复制
发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Strippoli, Giovanni F.
中科院分区：
文献类型：
--
作者：
Pontone, Gianluca;Guaricci, Andrea I.;Strippoli, Giovanni F.
背景资料：为了确定使用有创血流储备分数（FFR）作为冠状动脉疾病（CAD）参考标准的无创测试的诊断性能。方法：使用Medlin、Embase以及文献引用、指南和研究综述，比较截至2017年3月发表的可疑CAD的无创测试与有创FFR。检测功能显著性冠状动脉病变的灵敏度最高的诊断测试是冠状动脉计算机断层扫描（CT）血管造影术188%（85%-90%）1，其次是冠状动脉CT血管造影术（FFRCT）得出的FFR [85%（81%-88%）]、正电子发射断层扫描（PET）[85%（82%-88%）]、负荷心脏磁共振（负荷CMR）[81%（79%-84%）]，负荷心肌CT灌注联合冠状动脉CT血管造影[79%（74%-83%）]，负荷心肌CT灌注[77%（73%-80%）]，负荷超声心动图（Echo）[72%（64%-78%）]和负荷单光子发射计算机断层扫描（SPECT）[64%（60%-68%）]。负荷心肌CT灌注联合冠状动脉CT血管造影、负荷CMR和PET诊断冠心病的特异性最高，分别为91%（88%~ 93%）、91%（90%~ 93%）和87%（86%~ 89%）。在冠状动脉CT血管造影、负荷心脏MR和PET中添加正负荷心肌CT灌注，可提高检测性能，以识别需要进行有创冠状动脉评价的患者。(C)2019爱思唯尔B. V.保留所有权利。
Background: To determine diagnostic performance of non-invasive tests using invasive fractional flow reserve (FFR) as reference standard for coronary artery disease (CAD).Methods: Medlin, Embase, and citations of articles, guidelines, and reviews for studies were used to compare non-invasive tests with invasive FFR for suspected CAD published through March 2017.Results: Seventy-seven studies met inclusion criteria. The diagnostic test with the highest sensitivity to detect a functionally significant coronary lesion was coronary computed tomography (CT) angiography 188%(85%90%)1, followed by FFR derived from coronary CT angiography (FFRCT) [85%(81%-88%)], positron emission tomography (PET) [85%(82%-88%)], stress cardiac magnetic resonance (stress CMR)[81%(79%-84%)], stress myocardial CT perfusion combined with coronary CT angiography [79%(74%-83%)], stress myocardial CT perfusion [77%(73%-80%)], stress echocardiography (Echo) [72%(64%-78%)] and stress single-photon emission computed tomography (SPECT) [64%(60%-68%)]. Specificity to rule out CAD was highest for stress myocardial CT perfusion added to coronary CT angiography [91%(88%-93%)], stress CMR [91%(90%-93%)], and PET [87%(86%-89%)].Conclusion: A negative coronary CT angiography has a higher test performance than other index tests to exdude clinically-important CAD. A positive stress myocardial CT perfusion added to coronary CT angiography, stress cardiac MR, and PET have a higher test performance to identify patients requiring invasive coronary artery evaluation. (C) 2019 Elsevier B.V. All rights reserved.