We studied 92 consecutive patients without known coronary artery disease (CAD) who underwent Rb-82 PET, coronary calcium scoring (CCS) and invasive coronary angiography (ICA) within 6 months. EFV was computed from non-contrast CT by validated software and indexed to body surface-area (EFVi, cm3/m2). Ischemia was defined by 鈮?%difference of total perfusion deficit (quantified by validated software) between stress and rest. Obstructive stenosis was defined 鈮?0%luminal diameter stenosis.
Fifty three patients had both ischemia and stenosis. Compared to those without, patients with both having ischemia and stenosis had significantly higher CCS (1125 卤 1230 vs. 626 卤 690, p = 0.02) and EFVi (64.6 卤 20.6 vs. 49.7 卤 14.2 cm3/m2, p = 0.0002). On multivariable analysis after adjusting age, gender, cardiovascular risk factors, chest pain, and CCS (鈮?00), only elevated EFVi (>68.1 cm3/m2) significantly predicted concurrent presence of both ischemia and stenosis (odds ratio 6.18, 95%confidence interval 1.73-22.01, p = 0.005). Area under the receiver-operator-characteristic analysis demonstrated a trend towards improved incremental prediction of concurrent myocardial ischemia and obstructive stenosis over age, gender, chest pain, and high CCS (0.73 vs. 0.65, p = 0.09).
Our study suggests that elevated EFVi measured using non-contrast CT may be related to concurrent presence of both ischemia and stenosis.