Introduction
Methods
Statistical Analysis
Results
Summary of Studies Examining TID
Studies of Diagnostic Performance
Study | Stress/tracer | TID ratio (quant or qual) | # SPECT vs coronary angiography or CTA | Cardiac risk factors | Cardiac characteristics |
---|---|---|---|---|---|
Xu et al28
62.4 ± 10.0 years 62% men | Exercise Tc 99m | 1.19 (quant) | SPECT: 547 pts, angiography or CTA: 215 pts | Smoking 15%, HTN 59%, DM 18%, Dyslipidemia 50% | Angina 17% |
Kinoshita et al29
63.1 ± 7.8 years 87% men | Exercise Tc 99m | 1.012 (quant) | SPECT: 75 pts, angiography or CTA: 55 pts | N/A | N/A |
Petretta et al30
63 ± 9 years 75% men | Ex and Pharm Tc 99m | 1.19 (quant) | SPECT: 692 pts, angiography or CTA: 242 pts | Smoking 47%, HTN 88%, DM 100%, Dyslipidemia 75% | Angina 31%, MI 16% |
Weis et al1
58 years 78% men | Exercise Tl 201 | 1.12 (quant and qual) | SPECT: 89 pts, angiography or CTA: 89 pts | N/A | N/A |
Chouraqui et al6
67 ± 3 years 47% men | Pharm Tl 201 | 1.12 (quant) | SPECT: 73 pts, angiography or CTA: 73 pts | N/A | MI 33% |
Emmett et al31
68 ± 10 years 64% men | Adenosine Tc 99m | 1.19 (quant) | SPECT: 175 pts, angiography or CTA: 55 pts | HTN 82%, DM 81% | N/A |
Fallahi et al18
56 ± 11 years 23% men | Pharm Tc 99m | 1.17 (quant) | SPECT: 86 pts, angiography or CTA: 38 pts | Smoking 17%, HTN 55%, Dyslipidemia 36% | N/A |
Emmett et al32
72 ± 8 years, 47% men | Ex and Pharm Tc 99m | 1.22 (quant and qual) | SPECT: 103 pts, angiography or CTA: 103 pts | DM 58% | N/A |
Marcassa et al5
61 ± 8 years % men N/A | Ex and Pharm Tc 99m | 1.24 (quant) | SPECT: 234 pts, angiography or CTA: 186 pts | HTN 33%, DM 5%, Dyslipidemia 42% | Angina 47%, MI 63% |
Rischpler et al27
64 ± 11 years 58% men | Pharm Rb 82 | 1.13 (quant) | SPECT: 265 pts, angiography or CTA: 81 pts | Smoking 26%, HTN 84%, DM 37%, Dyslipidemia 58% | MI 26%, PCI 42% |
Mazzanti et al33
66 ± 11 years % men N/A | Exercise Dual | 1.22 (quant) | SPECT: 228 pts, angiography or CTA: 174 pts | N/A | MI 35%, CABG 33% |
Abidov et al34
69 ± 11.4 years 54% men | Pharm Dual | 1.36 (quant) | SPECT: 356 pts, angiography or CTA: 179 pts | HTN 70%, DM 31% | Angina 48% |
Golzar et al12
62 ± 13 50% men (validation group) | Pharm Tc 99m | 1.31 (quant) | SPECT: 647 pts, angiography or CTA: 547 pts | HTN 86%, Dyslipidemia 63% | Chest pain 54% |
Study | Definition of severe and extensive CAD | Software used for TID calculation |
---|---|---|
Xu et al28
| ≥70% LM or proximal LAD or ≥90% of ≥2 coronary vessels | Cedars Sinai QPS and QGS software |
Kinoshita et al29
| ≥75% reduction of luminal diameter of ≥2 coronary vessels | GMS-550 A Toshiba workstation Formula used for calculation (Mean A EX/Mean A rest) |
Petretta et al30
| ≥70% proximal LAD or ≥90% of ≥2 coronary vessels | Cedars Sinai software |
Weis et al1
| ≥90% of ≥2 coronary vessels | Manual calculation form the anterior view planar images |
Chouraqui et al6
| ≥90% of 3 coronary vessels | Manual calculation form the anterior view planar images |
Emmett et al31
| ≥90% of LAD or ≥90% of ≥2 coronary vessels | Emory Cardiac toolbox |
Fallahi et al18
| Coronary artery index Gensini score used | Cedars Sinai Auto Quant software package |
Emmett et al32
| ≥90% of LAD or ≥90% of ≥2 coronary vessels | Emory Cardiac toolbox |
Marcassa et al5
| >50% diameter stenosis in major pericardial vessel modified Gensini score | Not specified |
Rischpler et al27
| Obstructive CAD (Cath/CTA) severity not specified | Card IQ Physio (GE healthcare) |
Mazzanti et al33
| ≥90% of proximal LAD or ≥90% of ≥2 coronary vessels | Cedars Sinai QPS and QGS software |
Abidov et al34
| ≥90% of proximal LAD or ≥90% ≥2 vessel disease | Cedars Sinai QPS software |
Golzar et al12
| ≥70% LM or proximal LAD or ≥90% of ≥2 coronary vessels | 4DM-SPECT version 5.1 |
Study | Sensitivity | Specificity | PPV | NPV |
---|---|---|---|---|
Xu et al28
| 56 | 90 | 56 | 90 |
Kinoshita et al29
| 91.4 | 76.9 | 79 | 90 |
Petretta et al30
| 27.5 | 92.9 | 59.3 | 76 |
Weis et al1
| 60 | 95 | 85 | 82 |
Chouraqui et al6
| 62.5 | 85 | – | – |
Emmett et al31
| 30.4 | 87.5 | 63.6 | 63.6 |
Fallahi et al18
| 66.7 | 70.8 | – | – |
Emmett et al32
| 30 | 93 | 79 | 63 |
Marcassa et al5
| 37 | 61 | 64 | 34 |
Rischpler et al27
| 21 | 95.8 | 77 | 63 |
Mazzanti et al33
| 77 | 92 | – | – |
Abidov et al34
| 73 | 88 | – | – |
Golzar et al12
| 7 | 98 | – | – |
Subgroup Analyses for Diagnostic Performance of TID
Studies of Prognostic Performance
Study | Demographics and follow-up | TID ratio (quant or qual), n(%) of pts with TID | Annualized cardiac outcomes |
---|---|---|---|
Abidov et al17
66.1 ± 12.8 years 50% men Ex and Pharm Dual | Primary study cohort: 1560 pts with normal perfusion; Secondary cohort: 2037 pts with normal or near-normal perfusion: 2.3 ± 0.7 years | 1.21 (quant) n = 390 (25%) | Outcome: cardiac death, MI, or coronary revascularization Normal perfusion (SSS = 0): (a) TID present: 2.4%·year−1; (b) No TID (i.e., lowest TID quartile): 0.6%·year−1
Normal/near-normal perfusion (SSS 0-3): (a) TID present: 2.2%·year−1; (b) Other 3 TID quartiles: 1.0%·year−1
|
Petretta et al14
64 ± 8 years 67% men Ex and Pharm Tc 99m | 672 pts with DM 2+ years | 1.19 (quant) n = 97 (14%) | Outcome: cardiac death or MI No ischemia + LVEF > 45%: (a) TID present: 4.9%·year−1
(b) No TID: 0.21%·year−1
Ischemia present + LVEF > 45%: (a) TID present: 5.4%·year−1
(b) No TID: 1.9%·year−1
Ischemia + LVEF ≤ 45%: (a) TID present: 7.2%·year−1
(b) No TID: 3.8%·year−1
|
Doukky et al19
58 ± 12 years 52% men Ex and Pharm Tc 99m | 1236 pts with normal perfusion 27 ± 9 (clinical events) 37 ± 8 months (mortality) | 1.16 (Ex) 1.22 (Pharm) (quant) n = 76 (6%) | Outcome: cardiac death or MI Overall: (a) TID present: 2.4%·year−1
(b) No TID: 0.4%·year−1
DM or CAD: (a) TID present: 5.9%·year−1
(b) No TID: 0.2%·year−1
|
Uz zaman et al15
56 ± 9 years 67% men Ex and Pharm Tc 99m | 2689 pts in a single-center 18 ± 4 months | 1.22 (quant) n = 189 (7%) | Outcome: fatal MI (a) TID + not revascularized: 3.3%·year−1
(b) TID + revascularized: 1.6%·year−1
(c) No TID: not reported Outcome: non-fatal MI (a) TID + not revascularized: 14.2%·year−1
(b) TID + revascularized: 3.3%·year−1
(c) No TID: not reported |
Lette et al16
61 ± 10 years 55% men Pharm Tl 201 | 510 total pts; Prognostic cohort: 187 undergoing non-cardiac surgery 12 months | 1.15 (quant) n = 45 (9%) | Outcome: cardiac death or MI (a) TID present: 58%·year−1
(b) Reversible defect: 19%·year−1
(c) Normal: 2%·year−1
|
Lette et al35
62 years 57% men Pharm Tl 201 | 753 pts 16 months | 1.15 (quant) n = 41 (5%) | Outcome: cardiac death or MI (a) TID present: 47.4%·year−1
(b) Reversible defect: 15.8%·year−1
(c) Normal: 2.0%·year−1
|
Thomas et al36
65 ± 12 years 62% men Ex and Pharm Tc 99m and Dual | 1612 pts 24 ± 7 months | Qualitative n = 371 (23%) | Outcome: cardiac death or MI Technetium: (a) TID present: 6%·year−1
(b) No TID: 1.5%·year−1
Dual isotope: (a) TID present: 3.8%·year−1
(b) No TID: 0.5%·year−1
|
De winter et al13
78 (IQR: 76-80) years 54% men Ex and Pharm Tc 99m | 294 pts aged ≥ 75 years old 26 months | 1.005 (quant) n = 147 | Outcome: all-cause death (a) TID present: 9.7%·year−1
(b) No TID: 5.0%·year−1
|