Diagnostic Performances of Computed TomographIc Coronary Angiography and Intravascular Ultrasound

Study Overview
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Brief Summary
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Diagnostic purposes of the coronary angiography is to detect stenosis (anatomy) and to detect ischemia related stenosis (function). Coronary angiography (CAG) is a gold standard invasive techniques, but has several limitations. Intravascular ultrasound (IVUS) provides tomographic intra-luminal images. Coronary computed tomographic angiography (CCTA) is helpful to assess precise anatomical information. Optimal functional criteria and their accuracy of IVUS and CCTA by fraction flow reserve (FFR) have not been compared yet.

Detailed Description
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Correlation between CCTA, IVUS and FFR will be evaluated. The presence of myocardial ischemia will be assessed by fractional flow reserve (FFR). Diagnostic performance (sensitivity, specificity, positive predictive/negative predictive values and diagnostic accuracy) of each modality will be assessed and compared.

Official Title
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Diagnostic Performances of the Computed Tomographic Coronary Angiography and IntraVascular UltraSound to Evaluate Ischemia Causing Coronary Artery Stenosis

Conditions
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Diagnosis Coronary Artery Disease

Intervention / Treatment
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* Procedure: diagnostic procedures CCTA, CAG, IVUS and FFR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients presenting chest pain suspected stable angina or unstable angina patients permit informed consents patients performed all the procedures including CCTA, IVUS and FFR and present coronary artery stenosis Exclusion Criteria: acute myocardial infarction ejection fraction less than 40% infarct related artery chronic renal insufficiency left main stenosis, in-stent restenosis and grafted vessels allergy in contrast agent and adenosine unable to get a informed consents

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 83 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CCTA-IVUS-FFR<br>Patients suspected ischemic heart disease by the symptom and CCTA and undergone IVUS and FFR in the Cath Lab with CAG enrolled consecutively. | Procedure: diagnostic procedures CCTA, CAG, IVUS and FFR<br>* Diagnostic procedures including computed tomography, coronary angiography, intravascular ultrasound, fractional flow reserve were performed in the patients suspected ischemic heart disease.<br>* Other names: FFR, Pressure Wire, St.Jude medical;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic accuracy | Evaluate and compare the diagnostic accuracy of the CCTA, IVUS and angiographic parameters for the prediction of myocardial ischemia (FFR<0.8) CCTA: % area stenosis IVUS: minimum lumen area Angiography: % diameter stenosis Diagnostic accuracy of each parameter: (true positive+true negative)/total cases | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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computed tomography, intravascular ultrasound, coronary stenosis, fractional flow reserve