Document Type
Article
Publication Date
6-2020
Abstract
Background: Fractional flow reserve (FFR) is considered the gold standard for diagnosis of coronary artery disease (CAD). Stress Cardiac magnetic resonance (SCMR) has been recently gaining traction as a non-invasive alternative to FFR.
Methods: Studies comparing the diagnostic accuracy of SCMR versus FFR were identified and analyzed using Review Manager (RevMan) 5.3 and Stata software.
Results: A total of 28 studies, comprising 2,387 patients, were included. The pooled sensitivity and specificity for SCMR were 86% and 86% at the patient level, and 82% and 88% at the vessel level, respectively. When the patient-level data were stratified based on the FFR thresholds, higher sensitivity and specificity (both 90%) were noted with the higher cutoff (0.75) and lower cutoff (0.8), respectively. At the vessel level, sensitivity and specificity at the lower FFR threshold were significantly higher at 88% and 89%, compared to the corresponding values for higher cutoff at 0.75. Similarly, meta-regression analysis of SCMR at higher (3T) resolution showed a higher sensitivity of 87% at the patient level and higher specificity of 90% at the vessel level. The highest sensitivity and specificity of SCMR (92% and 94%, respectively) were noted in studies with CAD prevalence greater than 60%.
Conclusions: SCMR has high diagnostic accuracy for CAD comparable to FFR at a spatial resolution of 3T and an FFR cut-off of 0.80. An increase in CAD prevalence further improved the specificity of SCMR.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Recommended Citation
Ullah, Waqas; Roomi, Sohaib; Abdullah, Hafez M.; Mukhtar, Maryam; Ali, Zain; Ye, Ping; Haas, Donald C.; and Figueredo, Vincent M., "Diagnostic Accuracy of Cardiac Magnetic Resonance Versus Fractional Flow Reserve: A Systematic Review and Meta-Analysis." (2020). Abington Jefferson Health Papers. Paper 24.
https://jdc.jefferson.edu/abingtonfp/24
PubMed ID
32494324
Language
English
Comments
This article is the author’s final published version in Cardiology Research, Volume 11, Issue 3, June 2020, Pages 145-154.
The published version is available at https://doi.org/10.14740/cr1028. Copyright © Ullah et al.
Publication made possible in part by support from the Thomas Jefferson University + Philadelphia University Open Access Fund