Evidence map›Paper›PMID 26467105›Full record

Trial reportCirculation. Cardiovascular imaging2015

Accuracy of Computed Tomographic Angiography and Single-Photon Emission Computed Tomography-Acquired Myocardial Perfusion Imaging for the Diagnosis of Coronary Artery Disease.

Armin Arbab-Zadeh, Marcelo F Di Carli, Rodrigo Cerci, Richard T George, Marcus Y Chen, Marc Dewey, Hiroyuki Niinuma, Andrea L Vavere, Aisha Betoko, Michail Plotkin and 7 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Circulation. 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 NCT00934037 (Multi Center Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Computed Tomography), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
4.6field-weighted citation impact, top 5% 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.

NCT00934037 phase3completednot on this map

Multi Center Combined Non-invasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Computed Tomography

TypeinterventionalSponsorJohns Hopkins UniversityRan2009 to 2017Enrolled444ConditionsArterial Occlusive Diseases, Coronary Disease, Heart Diseases, Myocardial IschemiaArms320 Volume Detector Computed Tomography, Other: Multidetector Computed Tomography - 320 detectors
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Trial
  4. Article
  5. Article
  6. Myocardial perfusion imaging in advanced coronary artery disease.European journal of clinical investigation · 2025
    Review
  7. Carotid plaque characteristics by computed Tomography: A diagnostic accuracy systematic review.International journal of cardiology. Heart & vasculature · 2025
    Review
  8. Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Multimodality Imaging in the Detection of Ischemic Heart Disease in Women.Journal of cardiovascular development and disease · 2022
    Review
  17. Article
  18. Review
  19. Quantitative myocardial perfusionJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022
    Article
  20. Article
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

17 authors at 6 institutions in 2 countries.

Armin Arbab-ZadehFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Marcelo F Di CarliFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.). mdicarli@partners.org.
Rodrigo CerciFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Richard T GeorgeFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Marcus Y ChenFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Marc DeweyFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Hiroyuki NiinumaFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Andrea L VavereFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Aisha BetokoFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Michail PlotkinFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Christopher CoxFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Melvin E ClouseFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Andrew E AraiFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Carlos E RochitteFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Joao A C LimaFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Jeffrey BrinkerFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
Julie M MillerFrom the Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.-Z., R.C., R.T.G., A.L.V., J.A.C.L., J.B., J.M.M.); Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard University, Boston, MA (M.D.C.); Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (M.Y.C., A.E.A.); Department of Radiology, Charité, Berlin, Germany (M.D., M.P.); Department of Medicine, Division of Cardiology, St. Luke's Hospital, Tokyo, Japan (H.N.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.B., C.C.); Department of Radiology, Beth Israel Deaconess MC, Harvard University, Boston, MA (M.E.C.); and Department of Medicine, Division of Cardiology at the Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil (C.E.R.).
St. Luke's International Hospital · JPBrigham and Women's Hospital · USHarvard University · USJohns Hopkins University · USNational Heart Lung and Blood Institute · USNational Institutes of Health · US

Funding

Coronary Flow Reserve to Assess Cardiovascular Inflammation (CIRT-CFR)R01HL132021 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DI CARLI, MARCELO F · 2016 to 2018
$1.8M
Quantification and Characterization of Coronary Atherosclerotic Plaque by CTK23HL098368 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI ZADEH, ARMIN A. · 2011 to 2015
$699k
Intramural NIH HHSNHLBI NIH HHS HL006138-04NHLBI NIH HHS K23-HL098368NHLBI NIH HHS R01 HL132021
6 · The paper itself

Abstract

backgroundEstablishing the diagnosis of coronary artery disease (CAD) in symptomatic patients allows appropriately allocating preventative measures. Single-photon emission computed tomography (CT)-acquired myocardial perfusion imaging (SPECT-MPI) is frequently used for the evaluation of CAD, but coronary CT angiography (CTA) has emerged as a valid alternative. METHODS AND

resultsWe compared the accuracy of SPECT-MPI and CTA for the diagnosis of CAD in 391 symptomatic patients who were prospectively enrolled in a multicenter study after clinical referral for cardiac catheterization. The area under the receiver operating characteristic curve was used to evaluate the diagnostic accuracy of CTA and SPECT-MPI for identifying patients with CAD defined as the presence of ≥1 coronary artery with ≥50% lumen stenosis by quantitative coronary angiography. Sensitivity to identify patients with CAD was greater for CTA than SPECT-MPI (0.92 versus 0.62, respectively; P<0.001), resulting in greater overall accuracy (area under the receiver operating characteristic curve, 0.91 [95% confidence interval, 0.88-0.94] versus 0.69 [0.64-0.74]; P<0.001). Results were similar in patients without previous history of CAD (area under the receiver operating characteristic curve, 0.92 [0.89-0.96] versus 0.67 [0.61-0.73]; P<0.001) and also for the secondary end points of ≥70% stenosis and multivessel disease, as well as subgroups, except for patients with a calcium score of ≥400 and those with high-risk anatomy in whom the overall accuracy was similar because CTA's superior sensitivity was offset by lower specificity in these settings. Radiation doses were 3.9 mSv for CTA and 9.8 for SPECT-MPI (P<0.001).

conclusionsCTA is more accurate than SPECT-MPI for the diagnosis of CAD as defined by conventional angiography and may be underused for this purpose in symptomatic patients. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037.

Indexed as

AgedAged, 80 and overCoronary AngiographyCoronary Artery DiseaseFemaleHumansMaleMiddle AgedMultidetector Computed TomographyMyocardial Perfusion ImagingProspective StudiesReproducibility of ResultsROC CurveTomography, Emission-Computed, Single-Photoncoronary angiographycoronary artery diseasemyocardial ischemiamyocardial perfusion imagingROC curve

Identifiers

PMID26467105
PMCPMC6604852
OpenAlexW2555347348

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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.