Purpose: The present meta-analysis illustrates the accuracy of myocardial perfusion SPECT (MPS) to diagnose functional stenotic coronary artery disease (CAD) with fractional flow reserve (FFR) as standard reference.
Methods: All investigators screened and selected studies that compared MPS with FFR in symptomatic patients with suspected CAD. Patients and study characteristics were independently extracted by two investigators; differences were resolved by consensus.
Results: 13 articles, including 1,017 patients, 699 vessels were included in the study. No significant publication bias was detected (P=0.65). At the patient level, the summary sensitivity and specificity were 77% (95% confidence interval [CI], 70-83%) and 77% (95%CI, 67-84%) for MPS. Vessel-level pooled sensitivity was 66% (95%CI, 57-74%) and specificity was 81% (95%CI, 70-89%). The overall diagnostic performance of MPS was moderate. [The area under the summary receiver operating characteristic (sROC) curve was 0.83]. No study influenced the pooled results larger than 0.03.
Conclusions: The accuracy between FFR and MPS SPECT was moderate.
Keywords: Coronary artery disease; Fractional flow reserve; Myocardial perfusion SPECT; Quantitative coronary angiography.
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.