In patients with stable chest pain and suspected or established CAD, FFR-CT has a high diagnostic performance when compared against invasive FFR as the reference standard: 82% specificity and 74% PPV [33]. FFR-CT provides incremental improvement in the accuracy over CCTA alone (84% versus 59%), mitigating the high sensitivity/low specificity tradeoff of CCTA [33]. Another study of patients with suspected and established CAD (no data provided on clinical symptoms) has demonstrated that FFR-CT has correctly reclassified 68% of false-positive patients as true negatives, highlighting the potential role of FFR-CT as a gatekeeper to cardiac catheterization [35,36]. MRA Coronary Arteries Without and With IV Contrast Coronary MRA does not include delayed gadolinium enhancement or viability. Coronary MRA can demonstrate lumen narrowing of the proximal coronary arteries. There is limited data on the use of MRA coronary arteries without and with IV contrast in a symptomatic patient with a high probability for CAD. In a single-center prospective study in patients with suspected CAD, 82% sensitivity, 90% specificity, 88% PPV, and 86% NPV for detecting significant CAD were demonstrated [40]. There are no relevant data evaluating MRA coronary arteries without and with IV contrast in symptomatic patients with a high probability for CAD. MRA Coronary Arteries Without IV Contrast There is limited data on the use of MRA coronary arteries without IV contrast in symptomatic patient with a high probability for CAD. Chronic Chest Pain-High Probability of CAD high sensitivity (88%), moderate specificity (72%), a moderate PPV (71%), and a high NPV (88%) with an AUC of 0.87 for detecting significant coronary artery stenosis were demonstrated [41].
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. In patients with stable chest pain and suspected or established CAD, FFR-CT has a high diagnostic performance when compared against invasive FFR as the reference standard: 82% specificity and 74% PPV [33]. FFR-CT provides incremental improvement in the accuracy over CCTA alone (84% versus 59%), mitigating the high sensitivity/low specificity tradeoff of CCTA [33]. Another study of patients with suspected and established CAD (no data provided on clinical symptoms) has demonstrated that FFR-CT has correctly reclassified 68% of false-positive patients as true negatives, highlighting the potential role of FFR-CT as a gatekeeper to cardiac catheterization [35,36]. MRA Coronary Arteries Without and With IV Contrast Coronary MRA does not include delayed gadolinium enhancement or viability. Coronary MRA can demonstrate lumen narrowing of the proximal coronary arteries. There is limited data on the use of MRA coronary arteries without and with IV contrast in a symptomatic patient with a high probability for CAD. In a single-center prospective study in patients with suspected CAD, 82% sensitivity, 90% specificity, 88% PPV, and 86% NPV for detecting significant CAD were demonstrated [40]. There are no relevant data evaluating MRA coronary arteries without and with IV contrast in symptomatic patients with a high probability for CAD. MRA Coronary Arteries Without IV Contrast There is limited data on the use of MRA coronary arteries without IV contrast in symptomatic patient with a high probability for CAD. Chronic Chest Pain-High Probability of CAD high sensitivity (88%), moderate specificity (72%), a moderate PPV (71%), and a high NPV (88%) with an AUC of 0.87 for detecting significant coronary artery stenosis were demonstrated [41].