ArticleEuropean heart journal2022
Functional stress imaging to predict abnormal coronary fractional flow reserve: the PACIFIC 2 study.
Article in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07371247 (Based on ctDNA-MRD Guided Adjuvant Treatment Escalation After Definitive Chemoradiotherapy for Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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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.
Based on ctDNA-MRD Guided Adjuvant Treatment Escalation After Definitive Chemoradiotherapy for Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma: a Study on Safety and Efficacy
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Diagnostic accuracy of non-invasive cardiac imaging modalities in patients with a history of coronary artery disease: a meta-analysis.Heart (British Cardiac Society) · 2024Pooled it
- Recent Advances in SPECT Myocardial Perfusion Tracers: Tc-99m-4BOH.Current cardiology reports · 2026Review
- Stress CMR versus SPECT for the detection of coronary artery disease: meta-analysis and implications for the German healthcare.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Blunted heart rate response during dipyridamole stress SPECT is associated with cardiovascular outcomes in an all-comers cohort.BMC cardiovascular disorders · 2026Article
- Association of left ventricular mass with discordant stress cardiac magnetic resonance and coronary angiography.European heart journal. Cardiovascular Imaging · 2026Observational
- Impact of myocardial perfusion abnormalities on clinical outcomes in patients treated with percutaneous coronary intervention for chronic total occlusions.European heart journal. Imaging methods and practice · 2026Article
- Efficacy of coronary computed tomography angiography and its fractional flow reserve in predicting myocardial ischemia in patients with obstructive coronary artery disease with positron emission tomography myocardial perfusion imaging as a reference standard.Quantitative imaging in medicine and surgery · 2026Article
- Impact of myocardial scar burden on microvascular resistance reserve in patients with coronary artery disease.European journal of nuclear medicine and molecular imaging · 2025Article
- Myocardial perfusion imaging in advanced coronary artery disease.European journal of clinical investigation · 2025Review
- Homogeneity of the coronary microcirculation in angina with non-obstructive coronary artery disease.European heart journal. Cardiovascular Imaging · 2025Article
- Diagnostic performance of quantitative perfusion cardiac magnetic resonance imaging in patients with prior coronary artery disease.European heart journal. Cardiovascular Imaging · 2025Article
- Observational
- The diagnostic performance of quantitative flow ratio and perfusion imaging in patients with prior coronary artery disease.European heart journal. Cardiovascular Imaging · 2023Article
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- CCTA-based CABG SYNTAX Score: a tool to evaluate completeness of coronary segment revascularization after bypass surgery.The international journal of cardiovascular imaging · 2023Article
- Impact of cardiac history and myocardial scar on increase of myocardial perfusion after revascularization.European journal of nuclear medicine and molecular imaging · 2023Article
- Phenotyping heart failure by nuclear imaging of myocardial perfusion, metabolism, and molecular targets.European heart journal. Cardiovascular Imaging · 2023Review
- Role of cardiac imaging in management of heart failure.The Korean journal of internal medicine · 2023Review
- The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations.Current atherosclerosis reports · 2023Review
- The year in cardiovascular medicine 2022: the top 10 papers in cardiovascular imaging.European heart journal · 2023Article
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Authors and funding
18 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe diagnostic performance of non-invasive imaging in patients with prior coronary artery disease (CAD) has not been tested in prospective head-to-head comparative studies. The aim of this study was to compare the diagnostic performance of qualitative single-photon emission computed tomography (SPECT), quantitative positron emission tomography (PET), and qualitative magnetic resonance imaging (MRI) in patients with a prior myocardial infarction (MI) or percutaneous coronary intervention (PCI). METHODS AND
resultsIn this prospective clinical study, all patients with prior MI and/or PCI and new symptoms of ischaemic CAD underwent 99mTc-tetrofosmin SPECT, [15O]H2O PET, and MRI, followed by invasive coronary angiography with fractional flow reserve (FFR) in all coronary arteries. All modalities were interpreted by core laboratories. Haemodynamically significant CAD was defined by at least one coronary artery with an FFR ≤0.80. Among the 189 enrolled patients, 63% had significant CAD. Sensitivity was 67% (95% confidence interval 58-76%) for SPECT, 81% (72-87%) for PET, and 66% (56-75%) for MRI. Specificity was 61% (48-72%) for SPECT, 65% (53-76%) for PET, and 62% (49-74%) for MRI. Sensitivity of PET was higher than SPECT (P = 0.016) and MRI (P = 0.014), whereas specificity did not differ among the modalities. Diagnostic accuracy for PET (75%, 68-81%) did not statistically differ from SPECT (65%, 58-72%, P = 0.03) and MRI (64%, 57-72%, P = 0.052). Using FFR < 0.75 as a reference, accuracies increased to 69% (SPECT), 79% (PET), and 71% (MRI).
conclusionIn this prospective head-to-head comparative study, SPECT, PET, and MRI did not show a significantly different accuracy for diagnosing FFR defined significant CAD in patients with prior PCI and/or MI. Overall diagnostic performances, however, were discouraging and the additive value of non-invasive imaging in this high-risk population is questionable.
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