{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:15:37Z","timestamp":1787962537313,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Artificial intelligence\u2013guided quantitative computed tomography ischemia (AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      ) is a novel machine\u2010learning method for predicting myocardial ischemia from coronary computed tomography angiography (CCTA). This observational cohort study aimed to compare the long\u2010term prognostic value of AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      with hybrid CCTA\/positron emission tomography (PET) myocardial perfusion imaging in suspected coronary artery disease (CAD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Symptomatic patients with suspected CAD underwent CCTA with selective downstream PET to detect ischemic CAD. Blinded reanalysis of CCTA images was done using the AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      algorithm, providing a binary result (normal versus abnormal).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In the full analysis set (n=2271), hybrid CCTA\/PET imaging was successful in 94% of the patients and AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      evaluation was feasible in 83%, resulting in a per\u2010protocol set of 1772 patients (19% with ischemic CAD on hybrid CCTA\/PET and 25% with abnormal AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      ). There was moderate\u2010to\u2010substantial agreement between the methods (Cohen\u2019s \u03ba=0.61). During a median follow\u2010up of 7.0\u2009years, 177 (10%) patients experienced the composite end point of all\u2010cause death, myocardial infarction, or unstable angina. Ischemic CAD on hybrid CCTA\/PET was predictive of the composite end point (hazard ratio [HR], 2.35 [95% CI, 1.62\u20133.40];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), after adjustment for clinical variables and early (6\u2010month) myocardial revascularization. Similarly, an abnormal (ischemic) AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      result was independently predictive of adverse outcomes (adjusted HR, 1.98 [95% CI, 1.39\u20132.80];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). The adjusted models, including either hybrid CCTA\/PET or AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      , demonstrated similar discriminative ability (C\u2010index 0.734 versus 0.729;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.53).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The AI\u2010QCT\n                      <jats:sub>ischemia<\/jats:sub>\n                      algorithm demonstrated long\u2010term prognostic value comparable to hybrid CCTA\/PET perfusion imaging in suspected CAD.\n                    <\/jats:p>\n                  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