Feasibility and Diagnostic Performance of Functional SYNTAX Score Derived From Dynamic Computed Tomography (CT) Myocardial Perfusion Imaging
Authors' conclusion
Noninvasive FSS derived from CT-MPI is feasible and has strong concordance with FSSinvasive. It allows accurate categorization of FSS in patients with multivessel coronary artery disease, in particular with severe calcification.
Study context
- Population
- Patients with multivessel CAD who underwent dynamic CT myocardial perfusion imaging (CT-MPI) + coronary CT angiography and invasive coronary angiography or fractional flow reserve (FFR) within 4 weeks
- Participants
- 119 patients305 obstructive lesions
- Comparison
- CT-MPI-derived functional SYNTAX score (FSSCT-MPI) vs CT-FFR-derived FSS (FSSCT-FFR), with invasive FSS as reference
- Outcome
- Feasibility of FSSCT-MPI with reference to invasive FSS
Methodological detailsconsecutive inclusion
- Consecutive inclusion
Performance
As reported in the abstract
FSS
FSSCT-MPI
15.58
average · SD 13.03
FSSCT-FFR
16.18
average · SD 13.30
FSSinvasive
13.11
average · SD 12.22
- Agreement on risk classification by FSSCT-MPI tertiles, weighted κ (good)
- 0.808
- FSSCT-MPI correctly reclassified patients from intermediate- to high SYNTAX score group to low-score group vs FSSinvasive
- 27 (22.7%)
- Net reclassification index (P<0.001)
- 0.30
Further findings
| Outcome | FSSCT-MPI | FSSCT-FFR | P value |
|---|---|---|---|
| Detection of intermediate- to high-risk patients in severe calcification (reference FSSinvasive)FSSCT-MPI vs FSSCT-FFR · 0.976 vs 0.884 | P < 0.001 | ||
| AUC | 0.976 | 0.884 |
Original publication
Feasibility and Diagnostic Performance of Functional SYNTAX Score Derived From Dynamic CT Myocardial Perfusion Imaging. Circ Cardiovasc Imaging. Published 16 April 2024. doi:10.
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