著者
Toru Miyoshi Kazuhiro Osawa Hiroshi Ito Susumu Kanazawa Takeshi Kimura Hiroki Shiomi Sachio Kuribayashi Masahiro Jinzaki Akio Kawamura Hiram Bezerra Stephan Achenbach Bjarne L. Nørgaard
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.79, no.2, pp.406-412, 2015-01-23 (Released:2015-01-23)
参考文献数
29
被引用文献数
5 17

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 FFRCTcompared with invasive FFR. The aim of this post-hoc analysis was to assess the diagnostic performance of non-invasive FFRCTvs. standard stenosis quantification on coronary CTA in the Japanese subset of 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). FFRCTcorrectly 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-patient accuracy of FFRCTwas 83% with a high specificity of 76%, similar to the overall NXT trial findings.Conclusions:FFRCThas high diagnostic performance compared with invasive FFR in the Japanese subset of patients in the NXT trial. (Circ J 2015; 79: 406–412)