TY - JOUR
T1 - Coronary CT angiography-derived fractional flow reserve in-stable angina
T2 - association with recurrent chest pain
AU - Tækker Madsen, Kristian
AU - Veien, Karsten Tange
AU - Larsen, Pia
AU - Husain, Majed
AU - Deibjerg, Lone
AU - Junker, Anders
AU - Kusk, Martin Weber
AU - Thomsen, Kristian Korsgaard
AU - Rohold, Allan
AU - Jensen, Lisette Okkels
AU - Sand, Niels Peter Rønnow
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/10/20
Y1 - 2022/10/20
N2 - AIMS: The aim of this study was to evaluate the association between coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) and recurrent chest pain (CP) at 1-year follow-up in patients with stable angina pectoris (SAP).METHODS AND RESULTS: Study of patients (n = 267) with SAP who underwent CCTA and FFRCT testing; 236 (88%) underwent invasive coronary angiography; and 87 (33%) were revascularized. Symptomatic status at 1-year follow-up was gathered by a structured interview. Three different FFRCT algorithms were applied using the following criteria for abnormality: (i) 2 cm-FFRCT ≤0.80; (ii) d-FFRCT ≤0.80; and (iii) a combination in which both a d-FFRCT ≤0.80 and a ΔFFRCT ≥0.06 must be present in the same vessel (c-FFRCT). Patients were classified into two groups based on the FFRCT test result and revascularization: completely revascularized/normal (CRN), patients in whom all coronary arteries with an abnormal FFRCT test result were revascularized or patients with completely normal FFRCT test results, and incompletely revascularized (IR), patients in whom ≥1 coronary artery with an abnormal FFRCT test result was not revascularized. Recurrent CP was present in 62 (23%) patients. Classification of patients (CRN or IR) was significantly associated with recurrent CP for all applied FFRCT interpretation algorithms. When applying the c-FFRCT algorithm, the association with recurrent CP was found, irrespective of the extent of coronary calcification and the degree of coronary stenosis. A negative association between per-patient minimal d-FFRCT and recurrent CP was demonstrated, P < 0.005.CONCLUSION: An abnormal FFRCT test result is associated with an increased risk of recurrent CP in patients with new-onset SAP.
AB - AIMS: The aim of this study was to evaluate the association between coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) and recurrent chest pain (CP) at 1-year follow-up in patients with stable angina pectoris (SAP).METHODS AND RESULTS: Study of patients (n = 267) with SAP who underwent CCTA and FFRCT testing; 236 (88%) underwent invasive coronary angiography; and 87 (33%) were revascularized. Symptomatic status at 1-year follow-up was gathered by a structured interview. Three different FFRCT algorithms were applied using the following criteria for abnormality: (i) 2 cm-FFRCT ≤0.80; (ii) d-FFRCT ≤0.80; and (iii) a combination in which both a d-FFRCT ≤0.80 and a ΔFFRCT ≥0.06 must be present in the same vessel (c-FFRCT). Patients were classified into two groups based on the FFRCT test result and revascularization: completely revascularized/normal (CRN), patients in whom all coronary arteries with an abnormal FFRCT test result were revascularized or patients with completely normal FFRCT test results, and incompletely revascularized (IR), patients in whom ≥1 coronary artery with an abnormal FFRCT test result was not revascularized. Recurrent CP was present in 62 (23%) patients. Classification of patients (CRN or IR) was significantly associated with recurrent CP for all applied FFRCT interpretation algorithms. When applying the c-FFRCT algorithm, the association with recurrent CP was found, irrespective of the extent of coronary calcification and the degree of coronary stenosis. A negative association between per-patient minimal d-FFRCT and recurrent CP was demonstrated, P < 0.005.CONCLUSION: An abnormal FFRCT test result is associated with an increased risk of recurrent CP in patients with new-onset SAP.
KW - FFRCT
KW - chest pain
KW - coronary computed tomography angiography
KW - coronary revascularization
KW - stable angina pectoris
KW - Severity of Illness Index
KW - Predictive Value of Tests
KW - Computed Tomography Angiography/methods
KW - Humans
KW - Coronary Artery Disease/complications
KW - Angina, Stable/diagnostic imaging
KW - Coronary Vessels
KW - Coronary Stenosis/diagnostic imaging
KW - Fractional Flow Reserve, Myocardial
KW - Coronary Angiography/methods
KW - FFR
U2 - 10.1093/ehjci/jeab198
DO - 10.1093/ehjci/jeab198
M3 - Journal article
C2 - 34661645
SN - 2047-2404
VL - 23
SP - 1511
EP - 1519
JO - European Heart Journal - Cardiovascular Imaging
JF - European Heart Journal - Cardiovascular Imaging
IS - 11
ER -