Comprehensive Evaluation of Patients With Chest Pain Using Cardiac Computed Tomography: Value of Adding Regadenoson Stress Perfusion Imaging to Noninvasive Coronary Angiography
Phase: NA
Conditions: Coronary Artery Disease
Sponsor: University of Chicago

Official title: Comprehensive Evaluation of Patients with Chest Pain Using Cardiac 
Computed Tomography: Value of Adding Regadenoson Stress Perfusion 
Imaging to Noninvasive Coronary Angiography 
 
Brief title: Stress CT Perfusion in Patients with Chest Pain   
 
Identifier: 
NCT01969916 
 
Document date: May 16, 2018 
 
 

Study protocol 
 
We prospectively enrolled 150 consecutive patients referred for CT coronary angiography 
(CTCA) who agreed to undergo additional imaging with regadenoson (0.4mg, Astellas). Of the 
150 patients, 105 received regadenoson and underwent an additional CT scan at peak vasodilator 
stress. Images were acquired using retrospective gating (256-channel, Philips). Custom analysis 
software was used to generate 3D displays of normalized subendocardial x-ray attenuation co-
registered with coronary arteries, which allow detection of regadenoson stress-induced perfusion 
defects (SPD) in the territory of each coronary artery affected by disease. Hemodynamically 
significant stenosis was determined using two different criteria in parallel: (1) a combination of 
stenosis >50% on CTCA concomitant with an SPD, reflecting together the anatomical severity 
and the hemodynamic impact of stenosis, and (2) abnormal CT-FFR. These determinations were 
compared to each other on a per coronary artery basis. 
 
Statistical Methods 
 
To determine the level of agreement between the above two approaches for determination of 
hemodynamic significance of coronary stenosis, 2x2 contingency tables were created for each 
comparison with numbers of arteries where the two techniques indicated the presence or absence 
of significant disease. These tables were used to calculate the overall level of agreement (in 
percent of the total number of arteries studied), which was also assessed using kappa-statistics.