Key result
Older age linked to ~13% lower odds of diagnostic inaccuracy on pre-TAVI CT.
Why the study?
Data on predictors of diagnostic inaccuracy when detecting coronary artery disease using preprocedural CT angiography before TAVI were sparse.
What clinical and imaging factors predict the diagnostic inaccuracy of preprocedural CT angiography in detecting coronary artery stenosis in patients scheduled for TAVI?
Observational (n=192)
Blinded review of CT datasets
No
What clinical and imaging factors predict the diagnostic inaccuracy of preprocedural CT angiography in detecting coronary artery stenosis in patients scheduled for TAVI?
Younger patient age and insufficient CT image quality are independent predictors of inaccurate coronary artery stenosis detection by pre-TAVI-CT, suggesting a need for alternative diagnostic pathways in such patients.
Answers are grounded in this paper and cite their sources.
Younger age and poor CT quality were associated with pre-TAVI CT inaccuracy; hypothesis-generating for targeted protocols in TAVI candidates.
Background: The diagnostic performance of preprocedural CT angiography in detecting coronary artery disease (CAD) in patients scheduled for transcatheter aortic valve implantation (TAVI) has been reported. However, data on predictors of diagnostic inaccuracy are sparse. We sought to investigate clinical characteristics and imaging criteria that predict the inaccurate assessment of coronary artery stenosis based on pre-TAVI-CT. Methods: The patient- and vessel-level analysis of all CT datasets from 192 patients (mean age 82.1 ± 4.8 years; 63.5% female) without known CAD or severe renal dysfunction was performed retrospectively in a blinded fashion. Significant CAD was defined as a CAD-RADS™ 2.0 category ≥ 4 by CT. Invasive coronary angiography (ICA) served as the reference standard for relevant CAD (≥70% luminal diameter stenosis or fractional flow reserve ≤ 0.80). Pertinent clinical characteristics and imaging criteria of all true-positive (n = 71), false-positive (n = 30), false-negative (n = 4), and true-negative patient-level CT diagnoses (n = 87) for relevant stenosis according to ICA were assessed. Results: In the univariate per-patient analysis, the following parameters yielded discriminative power (p < 0.10) regarding inaccurate CAD assessment by pre-TAVI-CT: age, atrial fibrillation, scanner generation, and image quality. Factors independently associated with CT diagnostic inaccuracy were determined using multivariable logistic regression analysis: a younger age (odds ratio [OR] 0.87; 95% confidence interval [CI] 0.80 to 0.94; p < 0.01) and insufficient CT image quality (OR 0.6; CI 0.41 to 0.89; p < 0.01). Conclusions: Our results demonstrate younger age and poor CT image quality to predict less accurate CAD assessments by pre-TAVI-CT in comparison with ICA. Knowledge of these predictors may aid in more efficient coronary artery interpretations based on pre-TAVI-CT.
No takes yet. Share an insight, caveat, or question.
Renker et al. (2025) conducted an observational in Severe symptomatic aortic stenosis prior to TAVI (n=192). Younger age vs. Older age was evaluated on Inaccurate assessment of coronary artery stenosis by pre-TAVI-CT (diagnostic discordance with invasive coronary angiography at the patient level) (OR 0.87, 95% CI 0.80-0.94, p=<0.01). Younger patient age (OR 0.87) and insufficient CT image quality were independently associated with diagnostic inaccuracy of relevant coronary artery stenosis assessment by pre-TAVI-CT.
Synapse has enriched 10 related papers. Consider them for comparative context: