Evidence map›Paper›PMID 39567428›Full record

ArticleEuropean radiology2025

Prognostic significance of stress dynamic myocardial CT perfusion: comparison with CT-FFR and CT angiography stenosis-the multicenter VALIDITY trial.

Yan Yi, Dong Li, Cheng Xu, Limiao Zou, Xian-Bo Yu, Ming Wang, Gan Sun, Zhang Zhang, Yang Gao, Hui Liu and 3 more

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

13 authors.

Yan Yi *Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Dong Li *Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
Cheng XuDepartment of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Limiao ZouDepartment of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xian-Bo YuDepartment of CT Collaboration, Siemens Healthineers Ltd, Beijing, China.
Ming WangDepartment of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Gan SunInstitute of Clinical Medicine, Theranostics and Translational Research Facility, Peking Union Medical College Hospital, Beijing, China.
Zhang ZhangDepartment of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
Yang GaoDepartment of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Hui LiuDepartment of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Bin LuDepartment of Radiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Jia-Yin ZhangDepartment of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. andrewssmu@msn.com.
Yi-Ning WangDepartment of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. wangyining@pumch.cn.ORCID http://orcid.org/0000-0003-3193-2487

Funding

Beijing Natural Science Foundation Z210013Major International (Regional) Joint Research Project of National Natural Science Foundation of China 82020108018National High Level Hospital Clinical Research Funding 2022-PUMCH-A-097National High Level Hospital Clinical Research Funding 2022-PUMCH B-027
6 · The paper itself

Abstract

objectivesThis study aimed to investigate the prognostic significance of stress dynamic myocardial CT perfusion imaging (CTP) and determine whether it has incremental advantages over coronary computed tomography angiography (CTA)-derived parameters.

methodsThis prospective multicenter study included patients with suspected coronary artery disease who had undergone coronary CTA and CTP and were followed for 6 years. The endpoint was time-to-first major adverse cardiovascular event (MACE). MACEs included all-cause mortality, cardiac death, nonfatal myocardial infarction, unstable angina, late revascularization, and heart failure or aggravated angina symptoms requiring hospitalization. The CTP-derived absolute myocardial blood flow (MBF), relative MBF ratio (r-MBF), and the CTA-derived fractional flow reserve (CT-FFR) and stenosis were analyzed. The independent predictors, time-to-event distributions and the incremental prognostic value of CTP over CTA-derived parameters were assessed.

resultsA total of 226 patients (66.7 ± 11.3 years, 37.6% women) were enrolled with a median follow-up time of 1233 days. Twenty-one patients (9.29%) experienced MACEs and ten patients (4.4%) experienced hard MACEs. The r-MBF was the only independent predictor for MACEs in both all patients (hazard ratio [HR]: 0.82 (0.69-0.97), p = 0.01) and patients available for CTA stenosis (%) and CT-FFR calculation (HR: 0.72 (0.57-0.91), p = 0.006). The incremental prognostic significance of r-MBF over CT-FFR was confirmed after combining with CTA-derived parameters (concordance index: 0.919 vs. 0.811; p < 0.01). Patients with r-MBF < 0.77 were more likely to experience MACEs and have a lower average survival time (1565 vs. 1790 days; p < 0.01) after stent implantation.

conclusionsCTP-assessed r-MBF was independently correlated with MACEs and provided incremental prognostic significance. KEY POINTS: Question The prognostic significance of CT perfusion (CTP) lacks sufficient support from clinical research. Findings In this Chinese population, CTP has the strongest prognostic significance, over CT-Fractional Flow Reserve (FFR) and CTA stenosis in predicting major adverse cardiovascular events (MACEs). Clinical relevance Relative myocardial blood flow ratio had the strongest prognostic value and incremental advantages in predicting MACEs beyond CT-FFR and coronary CTA stenosis quantification, as well as advantages in patients with stents, aiding in personalized diagnosis and treatment plans.

Indexed as

Computed Tomography AngiographyCoronary AngiographyCoronary StenosisFractional Flow Reserve, MyocardialMyocardial Perfusion ImagingAgedFemaleHumansMaleMiddle AgedPrognosisProspective StudiesComputed tomographyCoronary artery diseaseFractional flow reserveMyocardial perfusion imagingPrognosis

Identifiers

PMID39567428

What OpenQuestion holds

Textmetadata
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.