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3. Temporal validation of the CT-PIRP prognostic model for mortality and renal replacement therapy initiation in chronic kidney disease patients.

Author

Gibertoni, D, Rucci, P, Mandreoli, M, Corradini, M, Martelli, D, Russo, G, Mancini, E, Santoro, A, Gibertoni, D, Rucci, P, Mandreoli, M, Corradini, M, Martelli, D, Russo, G, Mancini, E, and Santoro, A

Abstract

BACKGROUND: A classification tree model (CT-PIRP) was developed in 2013 to predict the annual renal function decline of patients with chronic kidney disease (CKD) participating in the PIRP (Progetto Insufficienza Renale Progressiva) project, which involves thirteen Nephrology Hospital Units in Emilia-Romagna (Italy). This model identified seven subgroups with specific combinations of baseline characteristics that were associated with a differential estimated glomerular filtration rate (eGFR) annual decline, but the model's ability to predict mortality and renal replacement therapy (RRT) has not been established yet. METHODS: Survival analysis was used to determine whether CT-PIRP subgroups identified in the derivation cohort (n = 2265) had different mortality and RRT risks. Temporal validation was performed in a matched cohort (n = 2051) of subsequently enrolled PIRP patients, in which discrimination and calibration were assessed using Kaplan-Meier survival curves, Cox regression and Fine & Gray competing risk modeling. RESULTS: In both cohorts mortality risk was higher for subgroups 3 (proteinuric, low eGFR, high serum phosphate) and lower for subgroups 1 (proteinuric, high eGFR), 4 (non-proteinuric, younger, non-diabetic) and 5 (non-proteinuric, younger, diabetic). Risk of RRT was higher for subgroups 3 and 2 (proteinuric, low eGFR, low serum phosphate), while subgroups 1, 6 (non-proteinuric, old females) and 7 (non-proteinuric, old males) showed lower risk. Calibration was excellent for mortality in all subgroups while for RRT it was overall good except in subgroups 4 and 5. CONCLUSIONS: The CT-PIRP model is a temporally validated prediction tool for mortality and RRT, based on variables routinely collected, that could assist decision-making regarding the treatment of incident CKD patients. External validation in other CKD populations is needed to determine its generalizability.

Published
2019

7. Impact of the introduction of organised screening for cervical cancer in Turin, Italy: cancer incidence by screening history 1992–98

Author

Nereo Segnan, S Patriarca, Guglielmo Ronco, Livia Giordano, B. Ghiringhello, Roberto Zanetti, G. Montanari, R Volante, S Pilutti, and Mancini E

Subjects
Cancer Research, medicine.medical_specialty, Epidemiology, cervical cancer, effectiveness, Uterine Cervical Neoplasms, Screening programme, medicine, Humans, Mass Screening, Mass screening, Vaginal Smears, Cervical cancer, Gynecology, Cervical screening, Obstetrics, business.industry, screening, Incidence, Incidence (epidemiology), organised programme, medicine.disease, Confidence interval, Italy, Oncology, Cancer incidence, Female, business
Abstract

After an organised cervical screening programme was introduced in Turin in 1992, the age-adjusted cervical cancer incidence ratio in 1992-98 was 0.81 (95% confidence interval (CI) 0.59-1.09) for invited vs not invited women and 0.25 (95% CI 0.13-0.50) for attenders vs non attenders. An organised screening programme can further reduce cervical cancer incidence in an area where substantial spontaneous activity was previously present.

Published
2005
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14. Do women ⩾50 years of age need as much screening as women <50 years after they have had negative screening results?

Author

Armaroli, P, primary, Gallo, F, additional, Bellomi, A, additional, Ciatto, S, additional, Consonni, D, additional, Davi, D, additional, Giorgi-Rossi, P, additional, Iossa, A, additional, Mancini, E, additional, Naldoni, C, additional, Polla, E, additional, Ronco, G, additional, Serafini, M, additional, Vergini, V, additional, Zanier, L, additional, Zappa, M, additional, and Segnan, N, additional

Published
2008
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25. Chest CT–derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy

Author

Alberto Monello, Gianluigi Patelli, Tommaso Nannini, Gianmarco Iannopollo, Antonio Esposito, Francesco De Cobelli, Anna Palmisano, Piergiorgio Turchio, Giovanni Landoni, Chiara Gnasso, Gianluca Pontone, Luisa Di Mare, Carlo Tacchetti, Clelia Di Serio, Antonio Colombo, Sandro Sironi, Marco Loffi, Fabio Ciceri, Andrea Biagi, Elisabetta Mancini, Daniele Andreini, Riccardo Leone, Pietro Sergio, Alberto Zangrillo, Giacomo Monti, Gianni Casella, Paola M.V. Rancoita, Alberto Cereda, Davide Vignale, Guglielmo Gallone, Francesco Giannini, Valeria Nicoletti, Davide Ippolito, Marco Toselli, Esposito, A, Palmisano, A, Toselli, M, Vignale, D, Cereda, A, Rancoita, P, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Biagi, A, Turchio, P, Landoni, G, Gallone, G, Monti, G, Casella, G, Iannopollo, G, Nannini, T, Patelli, G, Di Mare, L, Loffi, M, Sergio, P, Ippolito, D, Sironi, S, Pontone, G, Andreini, D, Mancini, E, Di Serio, C, De Cobelli, F, Ciceri, F, Zangrillo, A, Colombo, A, Tacchetti, C, Giannini, F, Esposito, Antonio, Palmisano, Anna, Toselli, Marco, Vignale, Davide, Cereda, Alberto, Rancoita, Paola Maria Vittoria, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Biagi, Andrea, Turchio, Piergiorgio, Landoni, Giovanni, Gallone, Guglielmo, Monti, Giacomo, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Patelli, Gianluigi, Di Mare, Luisa, Loffi, Marco, Sergio, Pietro, Ippolito, Davide, Sironi, Sandro, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Di Serio, Clelia, De Cobelli, Francesco, Ciceri, Fabio, Zangrillo, Alberto, Colombo, Antonio, Tacchetti, Carlo, and Giannini, Francesco

Subjects
Male, Thorax, medicine.medical_specialty, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine.artery, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Lung volumes, Aged, Retrospective Studies, medicine.diagnostic_test, SARS-CoV-2, business.industry, Tomography, X-ray computed, Hazard ratio, COVID-19, Interventional radiology, General Medicine, medicine.disease, Pulmonary hypertension, Pulmonary artery, Pneumonia, Italy, Hypertension, pulmonary, Radiology Nuclear Medicine and imaging, Chest, Female, Radiology, business, Cohort study
Abstract

Objectives Enlarged main pulmonary artery diameter (MPAD) resulted to be associated with pulmonary hypertension and mortality in a non-COVID-19 setting. The aim was to investigate and validate the association between MPAD enlargement and overall survival in COVID-19 patients. Methods This is a cohort study on 1469 consecutive COVID-19 patients submitted to chest CT within 72 h from admission in seven tertiary level hospitals in Northern Italy, between March 1 and April 20, 2020. Derivation cohort (n = 761) included patients from the first three participating hospitals; validation cohort (n = 633) included patients from the remaining hospitals. CT images were centrally analyzed in a core-lab blinded to clinical data. The prognostic value of MPAD on overall survival was evaluated at adjusted and multivariable Cox’s regression analysis on the derivation cohort. The final multivariable model was tested on the validation cohort. Results In the derivation cohort, the median age was 69 (IQR, 58–77) years and 537 (70.6%) were males. In the validation cohort, the median age was 69 (IQR, 59–77) years with 421 (66.5%) males. Enlarged MPAD (≥ 31 mm) was a predictor of mortality at adjusted (hazard ratio, HR [95%CI]: 1.741 [1.253–2.418], p p = 0.005), together with male gender, old age, high creatinine, low well-aerated lung volume, and high pneumonia extension (c-index [95%CI] = 0.826 [0.796–0.851]). Model discrimination was confirmed on the validation cohort (c-index [95%CI] = 0.789 [0.758–0.823]), also using CT measurements from a second reader (c-index [95%CI] = 0.790 [0.753;0.825]). Conclusion Enlarged MPAD (≥ 31 mm) at admitting chest CT is an independent predictor of mortality in COVID-19. Key Points •Enlargement of main pulmonary artery diameter at chest CT performed within 72 h from the admission was associated with a higher rate of in-hospital mortality in COVID-19 patients. •Enlargement of main pulmonary artery diameter (≥ 31 mm) was an independent predictor of death in COVID-19 patients at adjusted and multivariable regression analysis. •The combined evaluation of clinical findings, lung CT features, and main pulmonary artery diameter may be useful for risk stratification in COVID-19 patients.

Published
2020
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26. Assessement of Awareness of, Concerns and Attitudes Towards HIV-Related Court-Case Sentences in France in a Representative Sample of People Living with HIV (ANRS VESPA2 Survey)

Author

Marie Suzan-Monti, Bruno Spire, Antoine Vilotitch, Rosemary Dray-Spira, Patrick Yeni, Michel Celse, Baptiste Demoulin, Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Conseil national du sida et des hépatites virales [Paris, France], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Paris Diderot - Paris 7 (UPD7), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), The VESPA2 survey was sponsored and funded by the French National Agency for Research on Aids and Viral Hepatitis (ANRS), Grant No. 2010-176., ANRS VESPA2 study group : Lert F, Spire B, Carrieri P, Dray-Spira R, Hamelin C, Lorente N, Préau M, Suzan-Monti M, Mora M, Le Strat Y, Cuzin L, Meyer L, Rojas-Castro D, Fischer H, Allègre T, Mours P, Riou JM, Sordage M, Chennebault JM, Fialaire P, Rabier V, Froidure M, Huguet D, Leduc D, Pichancourt G, Wajsbrot A, Bourdeaux C, Foltzer A, Hoen B, Hustache-Mathieu L, Abgrall S, Barruet R, Bouchaud O, Chabrol A, Mattioni S, Mechai F, Jeantils V, Bernard N, Bonnet F, Hessamfar M, Lacoste D, Malvy D, Mercié P, Morlat P, Paccalin F, Pertusa MC, Pistone T, Receveur MC, Vandenhende MA, Dupont C, Freire Maresca A, Leporrier J, Rouveix E, Dargere S, de la Blanchardière A, Martin A, Noyon V, Verdon R, Rogeaux O, Beytout J, Gourdon F, Laurichesse H, Meier F, Mortier E, Simonpoli AM, Cordier F, Delacroix I, Garrait V, Elharrar B, Dominguez S, Lascaux AS, Lelièvre JD, Levy Y, Melica G, Buisson M, Piroth L, Waldner A, Gruat N, Leprêtre A, de Truchis P, Le Du D, Melchior JC, Sehouane R, Troisvallets D, Blanc M, Boccon-Gibod I, Bosseray A, Brion JP, Durand F, Leclercq P, Marion F, Pavese P, Brottier-Mancini E, Faba L, Roncato-Saberan M, Bollengier-Stragier O, Esnault JL, Leautez-Nainville S, Perré P, Froguel E, Nguessan M, Simon P, Colardelle P, Doll J, Godin-Collet C, Roussin-Bretagne S, Delfraissy JF, Duracinsky M, Goujard C, Peretti D, Quertainmont Y, Marionneau J, Aissi E, Van Grunderbeeck N, Denes E, Ducroix-Roubertou S, Genet C, Weinbreck P, Augustin-Normand C, Boibieux A, Cotte L, Ferry T, Koffi J, Miailhes P, Perpoint T, Peyramond D, Schlienger I, Brunel JM, Carbonnel E, Chiarello P, Livrozet JM, Makhloufi D, Dhiver C, Husson H, Madrid A, Ravaux I, de Severac ML, Thierry Mieg M, Tomei C, Hakoun S, Moreau J, Mokhtari S, Soavi MJ, Faucher O, Ménard A, Orticoni M, Poizot-Martin I, Atoui N, Baillat V, Faucherre V, Favier C, Jacquet JM, Le Moing V, Makinson A, Mansouri R, Merle C, Elforzli N, Allavena C, Aubry O, Besnier M, Billaud E, Bonnet B, Bouchez S, Boutoille D, Brunet C, Feuillebois N, Lefebvre M, Morineau-Le Houssine P, Mounoury O, Point P, Raffi F, Reliquet V, Talarmin JP, Ceppi C, Cua E, Dellamonica P, De Salvador-Guillouet F, Durant J, Ferrando S, Mondain-Miton V, Perbost I, Pillet S, Prouvost-Keller B, Pradier C, Pugliese P, Rahelinirina V, Roger PM, Rosenthal E, Sanderson F, Hocqueloux L, Niang M, Prazuck T, Arsac P, Barrault-Anstett MF, Ahouanto M, Bouvet E, Castanedo G, Charlois-Ou C, Dia Kotuba A, Eid-Antoun Z, Jestin C, Jidar K, Joly V, Khuong-Josses MA, Landgraf N, Landman R, Lariven S, L'hériteau F, Machado M, Matheron S, Michard F, Morau G, Pahlavan G, Phung BC, Prévot MH, Rioux C, Yéni P, Bani-Sadr F, Calboreanu A, Chakvetadze E, Salmon D, Silbermann B, Batisse D, Beumont M, Castiel P, Derouineau J, Eliaszewicz M, Gonzalez G, Jayle D, Karmochkine M, Kousignian P, Pavie J, Pierre I, Weiss L, Badsi E, Bendenoun M, Cervoni J, Diemer M, Durel A, Rami A, Sellier P, Ait-Mohand H, Amirat N, Bonmarchand M, Bourdillon F, Breton G, Caby F, Grivois JP, Katlama C, Kirstetter M, Paris L, Pichon F, Roudière L, Schneider L, Samba MC, Seang S, Simon A, Stitou H, Tubiana R, Valantin MA, Bollens D, Bottero J, Bui E, Campa P, Fonquernie L, Fournier S, Girard PM, Goetschel A, Guyon HF, Lacombe K, Lallemand F, Lefebvre B, Maynard JL, Meyohas MC, Ouazene Z, Pacanowski J, Picard O, Raguin G, Roussard P, Tourneur M, Tredup J, Valin N, Balkan S, Clavel F, de Verdière NC, De Castro N, de Lastours V, Ferret S, Gallien S, Gérard L, Goguel J, Lafaurie M, Lascoux-Combe C, Molina JM, Oksenhendler E, Pintado C, Ponscarme D, Rozenbaum W, Scemla A, Bonnard P, Lassel L, Lebrette MG, Lyavanc T, Mariot P, Missonnier R, Ohayon M, Pialoux G, Treilhou MP, Vincensini JP, Gilquin J, Hadacek B, Nait-Ighil L, Nguyen TH, Sobel A, Viard JP, Zak Dit Zbar O, Aumaître H, Eden A, Ferreyra M, Lopez F, Medus M, Neuville S, Saada M, Blum L, Perfezou P, Arvieux C, Chapplain JM, Revest M, Souala F, Tattevin P, Bord S, Borsa-Lebas F, Caron F, Chapuzet C, Debab Y, Gueit I, Etienne M, Fartoukh C, Feltgen K, Joly C, Robaday-Voisin S, Suel P, Khuong MA, Krausse J, Poupard M, Tran Van G, Cazorla C, Daoud F, Fascia P, Frésard A, Guglielminotti C, Lucht F, Bernard-Henry C, Cheneau C, Lang JM, de Mautort E, Partisani M, Priester M, Rey D, Majerholc C, Zucman D, Assi A, Lafeuillade A, de Jaureguiberry JP, Gisserot O, Aquilina C, du Clary FP, Alvarez M, Chauveau M, Delobel P, Garipuy D, Labau E, Marchou B, Massip P, Mularczyk M, Obadia M, Ajana F, Allienne C, Baclet V, de la Tribonnière X, Huleux T, Melliez H, Meybeck A, Riff B, Valette M, Viget N, Bastides F, Bernard L, Gras G, Guadagnin P, May T, Rabaud C, Dos Santos A, Poinsignon Y, Derradji O, Escaut L, Teicher E, Vittecoq D, Bantsima J, Caraux-Paz P, Patey O., Lissalde, Claire, and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Social Psychology, Social stigma, Cross-sectional study, Social Stigma, Stigma (botany), HIV Infections, 03 medical and health sciences, Discrimination, Psychological, 0302 clinical medicine, Criminalization, 5. Gender equality, Criminal Law, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, 10. No inequality, Psychiatry, Prejudice (legal term), Transients and Migrants, Depressive Disorder, Major, Stereotyping, 030505 public health, Public health, Public Health, Environmental and Occupational Health, HIV, Awareness, Middle Aged, 16. Peace & justice, Health psychology, Cross-Sectional Studies, Sexual Partners, Infectious Diseases, Attitude, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Criminal law, Female, Key population, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, 0305 other medical science, Psychology, Prejudice
Abstract

International audience; Some of the 12 criminal trials and sentences in France for HIV transmission in 1998-2011 attracted substantial public attention , with a possible negative impact on people living with HIV (PLWH) through reinforced stigma and discrimination. This analysis aimed to characterize PLWH enrolled in the representative ANRS-VESPA2 survey, aware of and concerned about convictions for HIV transmission. Being a migrant from Sub-Saharan Africa, having difficult socioeconomic conditions, having unprotected sex with one's main partner and concealing one's HIV status were all factors statistically associated with concern about the sentences. Participants tempted to press charges against someone for infecting them were more likely to be younger, women, not living in a couple, unemployed, and to report a major depressive disorder. Concern about HIV-related criminal proceedings among the most vulnerable PLWH do not reflect the actual risk of prosecution they are exposed to. Resumen En Francia, algunos de los 12 juicios y sentencias relacionados con la contaminación del VIH en 1998-2011 suscitaron con-siderablemente el interés público. Esto pudo impactar negativamente las personas viviendo con VIH (PVVIH) aumentando su estigmatización y discriminación. Este análisis busca caracterizar las PVVIH, de la encuesta ANRS-VESPA2, informadas acerca de esos juicios e inquietos por la posibilidad de implicación en uno de ellos. Ser inmigrante subsahariano, las con-diciones socio-económicas desfavorables, las relaciones sexuales no protegidas con la pareja principal, y ocultar el VIH, están asociados a la posibilidad de ser implicados en un juicio. Por otro lado, aquellos que han intentado presentar cargos por contaminación del VIH fueron mayoritariamente jóvenes, mujeres, personas viviendo solas, desempleados, y personas en depresión. Los juicios por contaminación del VIH entre las PVVIH más vulnerables no reflejan el riesgo de acusación al que están expuestos.

Published
2018
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27. Intra-dialytic blood oxygen saturation (SO2): association with dialysis hypotension (the SOGLIA Study)

Author

Claudia Perazzini, Luca Corazza, Silvana Savoldi, Filippo Aucella, Piergiorgio Bolasco, Antonio Santoro, Loreto Gesualdo, M. Tramonti, E. Mancini, Aurelio Limido, Francesco Scolari, Stefano Severi, Mauro Atti, Mancini, E, Perazzini, C, Gesualdo, L, Aucella, F, Limido, A, Scolari, F, Savoldi, S, Tramonti, M, Corazza, L, Atti, M, Severi, S, Bolasco, P, and Santoro, A

Subjects
Monitoring, Oxygen saturation, medicine.medical_treatment, 030232 urology & nephrology, Hemodynamics, 030204 cardiovascular system & hematology, Blood pressure, Dialysis hypotension, Hemodialysis, Oxygen, 03 medical and health sciences, 0302 clinical medicine, medicine, Dialysis, Oxygen saturation (medicine), business.industry, Extracorporeal circulation, Nephrology, Anesthesia, Arterial line, Hemodialysi, business, Central venous catheter
Abstract

Background Intradialytic hypotension (IDH) has a dramatic impact on the main outcomes of dialysis patients. Early warning of hemodynamic worsening during dialysis would enable preventive measures to be taken. Blood oxygen saturation (SO2) is used for hemodynamic monitoring in the critical care setting and may provide useful information about IDH onset. Aim To evaluate whether short- and medium-term variations in the SO2 signal (ST-SO2var, MT-SO2var,) during dialysis are a predictor of IDH. Methods In this 3-month observational cohort study, 51 hypotension-prone chronic hemodialysis (HD) patients, with vascular access by arteriovenous fistula (AVF) or central venous catheter (CVC), were enrolled. Continuous non-invasive blood SO2 was monitored (fc = 0.2 Hz) by an optical sensor on the arterial line of the extracorporeal circulation; blood pressure (every 30 min), symptoms and their time of appearance were noted. Predictive power of IDH was expressed by the area under curve (AUC) sensitivity and specificity based on intradialytic variations in SO2. Results A total of 1290 HD sessions were analyzed. Overall, off-line ST-SO2var analysis proved able to correctly predict IDH in 67 % of the sessions where IDH occurred. The best predictive performance was found in the presence of highly arterialized AVF (SO2 > 95 %) (75 % sensitivity; AUC 0.825; p

Published
2016
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28. The New Frontier of Cardiac Computed Tomography Angiography: Fractional Flow Reserve and Stress Myocardial Perfusion

Author

Marco Guglielmo, Daniele Andreini, Elisabetta Mancini, Edoardo Conte, Mauro Pepi, Saima Mushtaq, Gianluca Pontone, Andrea Igoren Guaricci, Giuseppe Muscogiuri, Mark G. Rabbat, Alberto Formenti, Virginia Beltrama, Andrea Annoni, Andrea Baggiano, Pontone, G, Muscogiuri, G, Andreini, D, Guaricci, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Conte, E, Beltrama, V, Annoni, A, Formenti, A, Mancini, E, Rabbat, M, and Pepi, M

Subjects
medicine.medical_specialty, CAD, Fractional flow reserve, 030204 cardiovascular system & hematology, Coronary artery disease, 030218 nuclear medicine & medical imaging, Myocardial perfusion, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Cardiac magnetic resonance imaging, medicine, medicine.diagnostic_test, business.industry, Gold standard (test), medicine.disease, Coronary arteries, Functional imaging, medicine.anatomical_structure, Radiology, Cardiology and Cardiovascular Medicine, business, Diagnosi, Artery
Abstract

The increased number of patients with coronary artery disease (CAD) in developed countries is of great clinical relevance and involves a large burden of the healthcare system. The management of these patients is focused on relieving symptoms and improving clinical outcomes. Therefore the ideal test would provide the correct diagnosis and actionable information. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography (ICA), but their diagnostic yield remains low with limited accuracy when compared to obstructive CAD at the time of ICA or invasive fractional flow reserve (FFR). Invasive FFR is considered the gold standard for the evaluation of functionally relevant CAD. Therefore, an urgent need for non-invasive techniques that evaluate both the functional and morphological severity of CAD is growing. Coronary computed tomography angiography (CCTA) has emerged as a unique non-invasive technique providing coronary artery anatomic imaging. More recently, the evaluation of FFR with CCTA (FFRCT) has demonstrated high diagnostic performance compared to invasive FFR. Additionally, stress myocardial computed tomography perfusion (CTP) represents a novel tool for the diagnosis of ischemia with high diagnostic accuracy. Compared to nuclear imaging and cardiac magnetic resonance imaging, both FFRCT and stress-CTP, allow us to integrate the anatomical evaluation of coronary arteries with the functional relevance of coronary artery lesions having the potential to revolutionize the diagnostic paradigm of suspected CAD. FFRCT and stress-CTP could be assimilated in diagnostic pathways of patients with stable CAD and will likely result in a decrease of invasive diagnostic procedures and costs. The current review evaluates the technical aspects and clinical experience of FFRCT and stress-CTP in the evaluation of functionally relevant CAD discussing the strengths and weaknesses of each approach. � 2016, Springer Science+Business Media New York.

Published
2016
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