Table 1

Studies included in the meta-analysis: design, patient, CT acquisition and selection characteristics

Study (ref),
publication year,
N
Study designFundingLocation/number of sitesPatientsType of scanner/
acquisition mode*
PLATFORM,
Douglas et al
2016,
n=177†18
Multicentre prospective cohort study,
CTA and FFRCT local site read
HeartFlowEurope/11
  • Clinically suspected CAD

  • Mean age, 61 years

  • Male gender, 60%

  • Mean pretest likelihood of obstructive CAD, 49%

  • Minimum CTA diameter stenosis ≥30%

Single-source or dual-source CT scanners with a minimum of 64 detector rows/
Prospective ECG triggering or retrospective gating
Aarhus study,
Nørgaard et al
2018,
n=67717
Single-centre observational registry, CTA and FFRCT local site readInvestigator-initiatedDenmark/1
  • Clinically suspected CAD

  • Mean age, 61 years

  • Male gender, 66%

  • Mean pretest likelihood of obstructive CAD, 45%

  • Minimum CTA diameter stenosis ≥30%

Somatom Definition Flash or Force, Siemens/
Prospective ECG triggering
ADVANCE Registry,
Patel et al
2020,
n=473719
Multicentre prospective registry,
CTA and FFRCT local site read
HeartFlowEurope, Japan, North America/38
  • Clinically suspected CAD

  • Mean age, 66 years

  • Male gender, 66%

  • Mean pretest likelihood of obstructive CAD, 62%

  • Minimum CTA diameter stenosis ≥30%

Single-source or dual-source CT scanners with a minimum of 64 detector rows/
Prospective ECG triggering or retrospective gating
NXT,
Ihdayhid et al
2019
n=20623
Subanalysis of prospective multicentre study,
CTA and FFRCT core-lab analysis
Investigator-initiated
(the original NXT study was funded by HeartFlow, but the follow-up study was performed by investigators independently of HeartFlow).
Europe, Japan, Australia, South Korea/9
  • Clinically suspected CAD

  • Mean age, 64 years

  • Male gender, 68%

  • Mean pretest likelihood of obstructive CAD, 54%

  • Min CTA diameter stenosis ≥30%

Single-source or dual-source CT scanners with a minimum of 64 detector rows/
Prospective ECG triggering or retrospective gating
Vancouver study,
McNabney et al
2019,
n=20724
Single-centre observational registry, CTA local site readInvestigator-initiatedCanada/1
  • Suspected stable CAD

  • Mean age, 62 years

  • Male gender, 76%

  • Mean pretest likelihood of obstructive CAD, information not available

  • Minimum CTA diameter stenosis ≥30%

Either 64-row (Discovery 750HD, GE) or 256-row (Revolution, GE) scanners/
Prospective ECG triggering or retrospective gating
Study (ref),
publication year,
N
FFRCT reading pointProportion of patients with
CTA stenosis ≥50 %/FFRCT≤0.80
Number of patients included in meta-analysis/% relative to the total number of patients in the mother study (reason for exclusion)
PLATFORM,
Douglas et al
2016,
n=177†18
The lowest per-patient value51%/39%177/100%
Aarhus study,
Nørgaard et al
2018,
n=67717
Two centimetres distal to stenosis in the event of lesion-specific ischaemia, otherwise the lowest per-patient value‡75%/36%584/86% (1-year follow-up data were not available in 93 patients)
ADVANCE Registry,
Patel et al
2020,
n=473719
The lowest per-patient value72%/66%4328/91% (1-year follow-up data were not available in 409 patients)
NXT,
Ihdayhid et al
2019,
n=20623
In a blinded fashion corresponding to the location of the pressure wire (lesion-specific ischaemia)81%/53%206/100%
Vancouver study,
McNabney et al
2019,
n=20724
Two centimetres distal to stenosis (lesion-specific ischaemia)65%/32%165/80% (42 patients were included in the ADVANCE Registry)
  • *Scan acquisition was performed in accordance with the Society of Cardiovascular Computed Tomography (SCCT) best practice guidelines in all studies.

  • †Only 201 out of the 584 patients included in the study had FFRCT prescribed, of whom FFRCT was analysable in 177.

  • ‡For this meta-analysis, the lowest per-patient FFRCT value was used.

  • ADVANCE, Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care registry; CAD, coronary artery disease; CTA, CT angiography; FFRCT, CTA-derived fractional flow reserve; NXT, Analysis of Coronary Blood Flow Using CT Angiography, Next Steps trial ; PLATFORM, Prospective Longitudinal Trial of FFRCT: Outcome and Resource impacts trial.