Unknown

Dataset Information

0

Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Safely Defers Invasive Coronary Angiography in Patients with Stable Coronary Artery Disease.


ABSTRACT: OBJECTIVES:In the United States, the real-world feasibility and outcome of using fractional flow reserve from coronary computed tomography angiography (FFRCT) is unknown. We sought to determine whether a strategy that combined coronary computed tomography angiography (CTA) and FFRCT could safely reduce the need for invasive coronary angiography (ICA), as compared to coronary CTA alone. METHODS:The study included 387 consecutive patients with suspected CAD referred for coronary CTA with selective FFRCT and 44 control patients who underwent CTA alone. Lesions with 30-90% diameter stenoses were considered of indeterminate hemodynamic significance and underwent FFRCT. Nadir FFRCT ? 0.80 was positive. The rate of patients having ICA, revascularization and major adverse cardiac events were recorded. RESULTS:Using coronary CTA and selective FFRCT, 121 patients (32%) had at least one vessel with ?50% diameter stenosis; 67/121 (55%) patients had at least one vessel with FFRCT ? 0.80; 55/121 (45%) underwent ICA; and 34 were revascularized. The proportion of ICA patients undergoing revascularization was 62% (34 of 55). The number of patients with vessels with 30-50% diameter of stenosis was 90 (23%); 28/90 (31%) patients had at least one vessel with FFRCT ? 0.80; 8/90 (9%) underwent ICA; and five were revascularized. In our institutional practice, compared to coronary CTA alone, coronary CTA with selective FFRCT reduced the rates of ICA (45% vs. 80%) for those with obstructive CAD. Using coronary CTA with selective FFRCT, no major adverse cardiac events occurred over a mean follow-up of 440 days. CONCLUSION:FFRCT safely deferred ICA in patients with CAD of indeterminate hemodynamic significance. A high proportion of those who underwent ICA were revascularized.

SUBMITTER: Rabbat M 

PROVIDER: S-EPMC7074264 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

altmetric image

Publications

Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Safely Defers Invasive Coronary Angiography in Patients with Stable Coronary Artery Disease.

Rabbat Mark M   Leipsic Jonathon J   Bax Jeroen J   Kauh Brian B   Verma Rina R   Doukas Demetrios D   Allen Sorcha S   Pontone Gianluca G   Wilber David D   Mathew Verghese V   Rogers Campbell C   Lopez John J  

Journal of clinical medicine 20200224 2


<h4>Objectives</h4>In the United States, the real-world feasibility and outcome of using fractional flow reserve from coronary computed tomography angiography (FFR<sub>CT</sub>) is unknown. We sought to determine whether a strategy that combined coronary computed tomography angiography (CTA) and FFR<sub>CT</sub> could safely reduce the need for invasive coronary angiography (ICA), as compared to coronary CTA alone.<h4>Methods</h4>The study included 387 consecutive patients with suspected CAD ref  ...[more]

Similar Datasets

| S-EPMC4751165 | biostudies-literature
| S-EPMC6553476 | biostudies-literature
| S-EPMC5716947 | biostudies-literature
| S-EPMC4830909 | biostudies-literature
| S-EPMC6992438 | biostudies-literature
| S-EPMC5394795 | biostudies-literature
| S-EPMC9234158 | biostudies-literature
| S-EPMC8452917 | biostudies-literature
| S-EPMC7929671 | biostudies-literature