Coronary disease & ACSMeta-analysis
Comparison of Photon-Counting and Energy-Integrating Computed Coronary Tomography Angiography for Coronary Artery Disease
- Systematic review and meta-analysis
- preregistered protocol
- PRISMA 2020
- random-effects
Authors' conclusion
Compared against conventional EID-CT, PCD-CT was associated with down-classification of stenosis severity, translating to fewer referrals for ICA and a greater rate of revascularization when angiography is undertaken.
Study context
- Population
- Adults with stable CAD undergoing coronary computed tomography angiography (CTA)
- Participants
- 11,350 adults · 15 studies
- Comparison
- PCD-CT vs EID-CT coronary CTA
- Outcome
- Vessel-level stenosis reclassification, downstream invasive coronary angiography (ICA) referral, and revascularization rates among those referred
Pooled result
As reported in the abstract
PCD-CT vs EID-CTOdds ratio (95% CI)P value
downstream ICA referral
0.71(0.63–0.79)
P < 0.0001revascularization among those undergoing ICA
1.43(1.14–1.79)
P = 0.0017- vessels with stenosis down-classified
- pooled absolute proportion 34.2% (95% CI 27.3–41.9); P < 0.0001
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| ICA referral, by CACS (subgroup) — PCD-CT vs EID-CT · CACS <400 | 0.62 (0.52–0.75) | P < 0.0001 | |
| ICA referral, by CACS (subgroup) — PCD-CT vs EID-CT · CACS ≥400 | 0.42 (0.16–1.11) | P = 0.08 | |
| 0.10.31310Odds ratio (log scale) |
Original publication
Comparison of Photon-Counting and Energy-Integrating Computed Coronary Tomography Angiography for Coronary Artery Disease. JACC Cardiovasc Imaging. Published 18 July 2026. doi:10.1016/j.jcmg.2026.05.021
Summarised from the published abstract; every number is checked against it