Utility of Coronary Computed Tomography Angiography in Patients Undergoing Transcatheter Aortic Valve Implantation: A Meta-Analysis and Meta-Regression Based on Published Data from 7458 Patients

Figures

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  Figure 1. PRISMA flow diagram.

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  Figure 2. Results from the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) analysis, illustrating a low overall risk of bias for the analysis cohort.

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  Figure 3. Sensitivity, specificity, positive and negative predictive value on the patient level, comparing coronary computed tomography with invasive angiography using a cut-off value of 50% lumen stenosis. Studies were stratified by year of publication [27,28,29,30,32,34,35,36,37,40,41,43,44,45,47,49,50,51,53].

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  Figure 4. Frequency of at least 50% stenosis in invasive coronary angiography across the included studies. The frequency of ≥50% stenosis was calculated as the sum of true positives and false negatives provided [27,28,29,30,32,34,35,36,37,40,41,43,44,45,47,49,50,51,53].

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  Figure 5. Association between frequency of coronary stenoses (>50%) or frequency of atrial fibrillation in the study cohort and the positive predictive value (PPV, red line) or 1—negative predictive value (NPV, blue line) in the studies based on the results of the meta-regression analysis. For details see text [27,28,29,30,32,34,35,36,37,40,41,43,44,45,47,49,50,51,53].

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  Figure 6. Illustration of the potential flow of patients based on the results of the current meta-analysis. Underlying data are based on patient-level data, comparing coronary computed tomography with invasive angiography, using a cut-off value of 50% lumen stenosis.

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  Figure 7. Summary receiver operating characteristic curve results for diagnostic test accuracy based on the patient-level bivariate meta-analysis, with a cut-off value of 50% luminal stenosis, comparing coronary computed tomography and invasive coronary angiography. Abbreviation: pAUC = partial area under the ROC curve.

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  Figure 8. Sensitivity, specificity, positive and negative predictive values on the segment, coronary artery, level. Only evaluable segments are considered for analysis. Comparison between coronary computed tomography and invasive angiography, using a cut-off value of 50% lumen stenosis, are displayed [27,28,32,40,41,42,43,45].

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  Figure 9. Sensitivity, specificity, positive and negative predictive values on the segment, coronary artery, level. Non-evaluable segments are considered as diseased/stenosed. Comparison between coronary computed tomography and invasive angiography, using a cut-off value of 50% lumen stenosis, are displayed [28,34,40,41,49,50,51].

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  Figure 10. Sensitivity, specificity, positive and negative predictive values of the proximal coronary artery segments. Comparison between coronary computed tomography and invasive angiography, using a cut-off value of 50% lumen stenosis [29,38,40,42,51,52].