Evidence map›Paper›PMID 25977111›Full record

Trial reportJournal of cardiovascular computed tomography

Combined coronary angiography and myocardial perfusion by computed tomography in the identification of flow-limiting stenosis - The CORE320 study: An integrated analysis of CT coronary angiography and myocardial perfusion.

Tiago A Magalhães, Satoru Kishi, Richard T George, Armin Arbab-Zadeh, Andrea L Vavere, Christopher Cox, Matthew B Matheson, Julie M Miller, Jeffrey Brinker, Marcelo Di Carli and 4 more

Open access · greenAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of cardiovascular computed tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
7.8field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Noninvasive Coronary Physiological Assessment Derived From Computed Tomography.Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Cardiac CT perfusion and FFRCardiovascular diagnosis and therapy · 2020
    Review
  11. Review
  12. Article
  13. Review
  14. Article
  15. Review
  16. Observational
  17. Review
  18. Review
  19. Myocardial computed tomography perfusion.Cardiovascular diagnosis and therapy · 2017
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Tiago A MagalhãesDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Brazil; Department of Radiology, Division of Cardiovascular CT/MR, Heart Hospital (HCOR), São Paulo, Sao Paulo, Brazil.
Satoru KishiDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Richard T GeorgeDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Armin Arbab-ZadehDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Andrea L VavereDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Christopher CoxDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Matthew B MathesonDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Julie M MillerDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Jeffrey BrinkerDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Marcelo Di CarliDepartment of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Frank J RybickiDepartment of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Carlos E RochitteDepartment of Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Brazil; Department of Radiology, Division of Cardiovascular CT/MR, Heart Hospital (HCOR), São Paulo, Sao Paulo, Brazil.
Melvin E ClouseDepartment of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA.
João A C LimaDepartment of Cardiology, Cardiology Division, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Blalock 524D1, 600 North Wolfe Street, Baltimore, MD 21287, USA. Electronic address: jlima@jhmi.edu.
Johns Hopkins Hospital · USJohns Hopkins University · USHarvard University · US

Funding

Mesenchymal Stem Cell CardiomyoplastyU54HL081028 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI HARE, JOSHUA M · 2005 to 2009
$12.1M
NHLBI NIH HHS U54 HL081028
6 · The paper itself

Abstract

backgroundThe combination of coronary CT angiography (CTA) and myocardial CT perfusion (CTP) is gaining increasing acceptance, but a standardized approach to be implemented in the clinical setting is necessary.

objectivesTo investigate the accuracy of a combined coronary CTA and myocardial CTP comprehensive protocol compared to coronary CTA alone, using a combination of invasive coronary angiography and single photon emission CT as reference.

methodsThree hundred eighty-one patients included in the CORE320 trial were analyzed in this study. Flow-limiting stenosis was defined as the presence of ≥50% stenosis by invasive coronary angiography with a related perfusion defect by single photon emission CT. The combined CTA + CTP definition of disease was the presence of a ≥50% stenosis with a related perfusion defect. All data sets were analyzed by 2 experienced readers, aligning anatomic findings by CTA with perfusion defects by CTP.

resultsMean patient age was 62 ± 6 years (66% male), 27% with prior history of myocardial infarction. In a per-patient analysis, sensitivity for CTA alone was 93%, specificity was 54%, positive predictive value was 55%, negative predictive value was 93%, and overall accuracy was 69%. After combining CTA and CTP, sensitivity was 78%, specificity was 73%, negative predictive value was 64%, positive predictive value was 0.85%, and overall accuracy was 75%. In a per-vessel analysis, overall accuracy of CTA alone was 73% compared to 79% for the combination of CTA and CTP (P < .0001 for difference).

conclusionsCombining coronary CTA and myocardial CTP findings through a comprehensive protocol is feasible. Although sensitivity is lower, specificity and overall accuracy are higher than assessment by coronary CTA when compared against a reference standard of stenosis with an associated perfusion defect.

Indexed as

Coronary CirculationAgedAged, 80 and overCoronary AngiographyCoronary StenosisCoronary VesselsFeasibility StudiesFemaleHumansMaleMiddle AgedMyocardial Perfusion ImagingPredictive Value of TestsProspective StudiesRadiographic Image Interpretation, Computer-AssistedReproducibility of ResultsCoronary CT angiographyHybrid imagingMultislice CTMyocardial CT perfusionMyocardial perfusion imaging

Identifiers

PMID25977111
PMCPMC4575835
OpenAlexW1934131980

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.