Evidence map›Paper›PMID 25592691›Full record

ArticleJACC. Cardiovascular imaging2015

Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia: a direct comparison to fractional flow reserve.

Hyung-Bok Park, Ran Heo, Bríain Ó Hartaigh, Iksung Cho, Heidi Gransar, Ryo Nakazato, Jonathon Leipsic, G B John Mancini, Bon-Kwon Koo, Hiromasa Otake and 5 more

Registry-linked trialOpen access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01233518 (Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography), which is not on this map. Cited by 115 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 3 pooled it
32.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01233518 nacompletednot on this map

Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography

TypeinterventionalSponsorHeartFlow, Inc.Ran2010 to 2011Enrolled285ConditionsCoronary Artery DiseaseArmsFFR
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 3 syntheses or guidelines pooled it, 282 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Predicting Chronic Myocardial Ischemia Using CCTA-Based Radiomics Machine Learning Nomogram.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022
    Trial
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  9. Article
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  11. Chronic ischemic heart disease: A nonuniform syndrome.American heart journal plus : cardiology research and practice · 2026
    Review
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  18. The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Review
  19. Review
  20. Article

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 5 countries.

Hyung-Bok ParkDepartment of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York; Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea; Cardiovascular Center, Myongji Hospital, Goyang, Korea.
Ran HeoDepartment of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York; Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
Bríain Ó HartaighDepartment of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York.
Iksung ChoDepartment of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York; Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
Heidi GransarDepartments of Imaging and Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Ryo NakazatoCardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.
Jonathon LeipsicDepartment of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
G B John ManciniDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Bon-Kwon KooDepartment of Medicine, Seoul National University Hospital, Seoul, South Korea.
Hiromasa OtakeDepartment of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Matthew J BudoffDepartment of Medicine, Harbor UCLA Medical Center, Los Angeles, California.
Daniel S BermanDepartments of Imaging and Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Andrejs ErglisDepartment of Medicine, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Hyuk-Jae ChangDivision of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
James K MinDepartment of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, New York. Electronic address: jkm2001@med.cornell.edu.
NewYork–Presbyterian Hospital · USCedars-Sinai Medical Center · USUniversity of British Columbia · CACornell University · USHarbor–UCLA Medical Center · USKobe University · JPPauls Stradiņš Clinical University Hospital · LVSeoul National University Hospital · KRSt. Luke's International Hospital · JPYonsei University · KR

Funding

Clinical and Translational Science CenterUL1TR000457 · NCATS · WEILL MEDICAL COLL OF CORNELL UNIV · PI IMPERATO-MCGINLEY, JULIANNE L · 2012 to 2016
$46.0M
Patient-Specific Coronary Hemodynamics by 3D PrintingR01HL118019 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI DUNHAM, SIMON, LIN, FAY YU-HUEI · 2013 to 2022
$5.8M
Gender-Specific Coronary Plaque Characteristics and Risk of Myocardial InfarctionR01HL115150 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI MIN, JAMES K · 2012 to 2016
$3.5M
NCATS NIH HHS UL1 TR000457NHLBI NIH HHS R01 HL115150NHLBI NIH HHS R01HL115150NHLBI NIH HHS R01 HL118019NHLBI NIH HHS R01HL118019
6 · The paper itself

Abstract

objectivesThis study evaluated the association between atherosclerotic plaque characteristics (APCs) by coronary computed tomographic angiography (CTA), and lesion ischemia by fractional flow reserve (FFR).

backgroundFFR is the gold standard for determining lesion ischemia. Although APCs by CTA-including aggregate plaque volume % (%APV), positive remodeling (PR), low attenuation plaque (LAP), and spotty calcification (SC)-are associated with future coronary syndromes, their relationship to lesion ischemia is unclear.

methods252 patients (17 centers, 5 countries; mean age 63 years; 71% males) underwent coronary CTA, with FFR performed for 407 coronary lesions. Coronary CTA was interpreted for <50% and ≥50% stenosis, with the latter considered obstructive. APCs by coronary CTA were defined as: 1) PR, lesion diameter/reference diameter >1.10; 2) LAP, any voxel <30 Hounsfield units; and 3) SC, nodular calcified plaque <3 mm. Odds ratios (OR) and net reclassification improvement of APCs for lesion ischemia, defined by FFR ≤0.8, were analyzed.

resultsBy FFR, ischemia was present in 151 lesions (37%). %APV was associated with a 50% increased risk of ischemia per 5% additional APV. PR, LAP, and SC were associated with ischemia, with a 3 to 5 times higher prevalence than in nonischemic lesions. In multivariable analyses, a stepwise increased risk of ischemia was observed for 1 (OR: 4.0, p < 0.001) and ≥2 (OR: 12.1, p < 0.001) APCs. These findings were APC dependent, with PR (OR: 5.3, p < 0.001) and LAP (OR: 2.1, p = 0.038) associated with ischemia, but not SC. When examined by stenosis severity, PR remained a predictor of ischemia for all lesions, whereas %APV and LAP were associated with ischemia for only ≥50%, but not for <50%, stenosis.

conclusions%APV and APCs by coronary CTA improve identification of coronary lesions that cause ischemia. PR is associated with all ischemia-causing lesions, whereas %APV and LAP are only associated with ischemia-causing lesions ≥50%. (Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography; NCT01233518).

Indexed as

Coronary AngiographyFractional Flow Reserve, MyocardialTomography, X-Ray ComputedCoronary OcclusionFemaleHumansMaleMiddle AgedPlaque, Atheroscleroticcoronary artery diseasecoronary computed tomography angiographycoronary plaquefractional flow reservemyocardial ischemia

Identifiers

PMID25592691
PMCPMC4297319
OpenAlexW1952254076

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.