Comparison of the Diagnostic Performance of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve in Patients With Versus Without Diabetes Mellitus (from the MACHINE Consortium)

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Comparison of the Diagnostic Performance of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve in Patients With Versus Without Diabetes Mellitus (from the MACHINE Consortium)

Nous, Fay M. A. (author): Erasmus MC, Netherlands; Erasmus MC, Netherlands

Coenen, Adriaan (author): Erasmus MC, Netherlands; Erasmus MC, Netherlands

Boersma, Eric (author): Erasmus MC, Netherlands

Kim, Young-Hak (author): Univ Ulsan, South Korea

Kruk, Mariusz B. P. (author): Inst Cardiol, Poland

Tesche, Christian (author): Med Univ South Carolina, SC 29425 USA

De Geer, Jakob, 1970- (author): Linköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping

Yang, Dong Hyun (author): Univ Ulsan, South Korea; Univ Ulsan, South Korea

Kepka, Cezary (author): Inst Cardiol, Poland

Schoepf, U. Joseph (author): Univ Ulsan, South Korea

Persson, Anders (author): Linköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping

Kurata, Akira (author): Erasmus MC, Netherlands; Ehime Univ, Japan

Budde, Ricardo P. J. (author): Erasmus MC, Netherlands; Erasmus MC, Netherlands

Nieman, Koen (author): Erasmus MC, Netherlands; Erasmus MC, Netherlands; Stanford Univ, CA 94305 USA

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EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC, 2019
2019
English.
In: American Journal of Cardiology. - : EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC. - 0002-9149 .- 1879-1913. ; 123:4, s. 537-543

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Coronary computed tomography angiography-derived fractional flow reserve (CT-FFR) is a noninvasive application to evaluate the hemodynamic impact of coronary artery disease by simulating invasively measured FFR based on CT data. CT-FFR is based on the assumption of a normal coronary microvascular response. We assessed the diagnostic performance of a machine-learning based application for on-site computation of CT-FFR in patients with and without diabetes mellitus with suspected coronary artery disease. The study population included 75 diabetic and 276 nondiabetic patients who were enrolled in the MACHINE consortium. The overall diagnostic performance of coronary CT angiography alone and in combination with CT-FFR were analyzed with direct invasive FFR comparison in 110 coronary vessels of the diabetic group and in 415 coronary vessels of the nondiabetic group. Per-vessel discrimination of lesion-specific ischemia by CT-FFR was assessed by the area under the receiver operating characteristic curves. The overall diagnostic accuracy of CT-FFR in diabetic patients was 83% and in nondiabetic patients 75% (p = 0.088), showing improvement over the diagnostic accuracy of coronary CT angiography, which was 58% and 65% (p = 0.223), respectively. In addition, the diagnostic accuracy of CT-FFR was similar between diabetic and nondiabetic patients per stratified CT-FFR group (CT-FFR amp;lt; 0.6, 0.6 to 0.69, 0.7 to 0.79, 0.8 to 0.89, amp;gt;= 0.9). The area under the curves for diabetic and nondiabetic patients were also comparable, 0.88 and 0.82 (p = 0.113), respectively. In conclusion, on-site machine-learning CT-FFR analysis improved the diagnostic performance of coronary CT angiography and accurately discriminated lesion-specific ischemia in both diabetic and nondiabetic patients suspected of coronary artery disease. (C) 2018 Elsevier Inc. All rights reserved.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

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By the author/editor: Nous, Fay M. A.; Coenen, Adriaan; Boersma, Eric; Kim, Young-Hak; Kruk, Mariusz B. ...; Tesche, Christia ...; show more...; De Geer, Jakob, ...; Yang, Dong Hyun; Kepka, Cezary; Schoepf, U. Jose ...; Persson, Anders; Kurata, Akira; Budde, Ricardo P ...; Nieman, Koen; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Radiology Nuclea ...

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By the university: Linköping University

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