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Flurpiridaz PET holds promise as new tracer for CAD detection

01 Aug 2020

Fluorine-18 flurpiridaz positron emission tomography (PET) myocardial perfusion imaging appears to be noninferior to technetium-99m–labeled single photon emission computed tomography (SPECT) for the detection of coronary artery disease (CAD), as well as the assessment of women, obese individuals, and patients undergoing pharmacological stress testing, results of a phase III trial have shown.

A total of 795 patients with known or suspected CAD from 72 clinical sites in the US, Canada, and Finland participated in this phase III prospective multicentre clinical study. Of the 755 participants who were evaluable (mean age, 62.3 years; 31 percent women) 55 percent had body mass index ≥30 kg/m2 and 71 percent had pharmacological stress.

Patients then underwent 1-day rest-stress (pharmacological or exercise) flurpiridaz PET and 1- or 2-day rest-stress Tc-99m–labeled SPECT and invasive coronary angiography (ICA). Three experts, who were blinded to clinical and ICA data, read the images.

Sensitivity of flurpiridaz PET (for detection of ≥50 percent stenosis by ICA) was 71.9 percent (95 percent confidence interval [CI], 67.0–76.3) and was significantly higher (p<0.001) than that with SPECT (53.7 percent, 95 percent CI, 48.5–58.8), but its specificity failed to meet the prespecified noninferiority criterion (76.2 percent, 95 percent CI, 71.8–80.1 vs 86.6 percent, 95 percent CI, 83.2–89.8; p=NS).

In receiver-operating characteristic curve analysis, flurpiridaz PET showed superior discrimination of CAD in the overall population, in women, obese individuals, and patients undergoing pharmacological stress testing (p<0.001 for all) compared with SPECT.

Flurpiridaz PET was also superior to SPECT for the following: defect size (p<0.001), image quality (p<0.001), diagnostic certainty (p<0.001), and radiation exposure (6.1±0.4 vs 13.4±3.2 mSv; p<0.001). In addition, flurpiridaz was safe and well tolerated.

A second phase III trial by the Food and Drug Administration is ongoing. 

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Most Read Articles
Elaine Soliven, 4 days ago

Switching from efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) to the new bictegravir/ emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) regimen maintained high rates of virological suppression in adults who are living with HIV*, according to a study presented at AIDS 2020.

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Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
Stephen Padilla, 4 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.
Jairia Dela Cruz, 3 days ago
Monthly prophylaxis with the fixed-dose combination of naphthoquine-azithromycin (NQAZ) is well tolerated and confers significant protection against infection with Plasmodium parasites among individuals residing in malaria-endemic areas in Southeast Asia, as shown in the results of a phase III trial.