Studies included in the meta-analysis: primary outcome analysis
| Study (ref), publication year, N | Primary outcome endpoint | Endpoint source | Endpoint adjudication | Follow-up | Primary endpoint frequency FFRCT>0.80 (no of patients with an event)/FFRCT≤0.80 (no of patients with an event) (statistical significance) |
| PLATFORM, Douglas et al 2016, n=177*18 | Composite of ACM, non-fatal MI or unplanned revascularisation for chest pain leading to urgent revascularisation | Clinical visits (97.4%), chart review (2.6%) | Independent clinical events committee whose members were blinded to clinical and coronary CTA/FFRCT data using standard prospectively determined definitions | 1 year | The endpoint was reported according to the patient management strategy and not the FFRCT result. (Overall, the endpoint occurred in two patients, 1.1%.) |
| Aarhus study, Nørgaard et al 2018, n=67717 | Composite of ACM, non-fatal MI, hospitalisation for unstable angina or unplanned revascularisation | Data were retrieved from Danish National registries* | Endpoint data were retrieved from national complete registries* r | Median (range) 2 (0.7–3.4) years | †3.9% (n=11)/9.4% (n=6) in the medical treatment only group and 6.6% (n=7) in those having ICA performed (no statistical testing) |
| ADVANCE Registry, Patel et al 2020, n=473719 | Composite of ACM, non-fatal MI or unplanned hospitalisation for ACS leading to revascularisation | Reported from each site to an electronically case record form | Independent clinical events committee whose members were blinded to clinical and coronary CTA/FFRCT data using standard prospectively determined definitions | 1 year | 0.7% (n=12)/1.4% (n=43) (RR 1.81, 95% CI 0.96 to 3.43; p=0.06) |
| NXT, Ihdayhid et al 2019, n=20623 | Composite of ACM, non-fatal MI or any revascularisation | Medical records or telephone interview | Clinical events were adjudicated by physicians at each site who were blinded to CTA and FFRCT data using standard determined definitions | Median (range) 4.7 (4.4–5.3) years | 13.4% (n=13)/73.4% (n=80) (HR 9.2, 95% CI 5.1 to 17; p<0.01) |
| Vancouver study, McNabney et al 2019, n=20724 | ACM, non-fatal MI, late revascularisation (>90 days) | Medical records and self-reported questionnaires | Clinical events were adjudicated by physicians who were blinded to CTA and FFRCT data using standard determined definitions | Median (IQR) 1.3 (0.7–2.4) years | 5.8% (n=8)/28.6% (n=18) (no statistical testing) |
*The Danish National Patient Registry records discharge diagnosis in accordance with the International Classification of Diseases classification system from all hospitalisations and outpatient clinic visits in Denmark. The Civil Registration Registry contains complete data on mortality.
†Cumulative incidence proportions.
ACM, all-cause mortality; CTA, CT angiography; ICA, invasive coronary angiography; MI, myocardial infarction; RR, relative risk.