Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study

Kristian Tækker Madsen; Bjarne Linde Nørgaard; Kristian Altern Øvrehus; Jesper Møller Jensen; Erik Parner; Erik Lerkevang Grove; Martin B. Mortensen; Timothy A. Fairbairn; Koen Nieman; Manesh R. Patel; Campbell Rogers; Sarah Mullen; Hans Mickley; Kristian Korsgaard Thomsen; Hans Erik Bøtker; Jonathon Leipsic; Niels Peter Rønnow Sand

doi:10.1016/j.jcct.2024.01.010

Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study

Kristian Tækker Madsen^*, Bjarne Linde Nørgaard, Kristian Altern Øvrehus, Jesper Møller Jensen, Erik Parner, Erik Lerkevang Grove, Martin B. Mortensen, Timothy A. Fairbairn, Koen Nieman, Manesh R. Patel, Campbell Rogers, Sarah Mullen, Hans Mickley, Kristian Korsgaard Thomsen, Hans Erik Bøtker, Jonathon Leipsic, Niels Peter Rønnow Sand

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

26 Downloads (Pure)

Abstract

Background: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFR_CT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. Methods: Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFR_CT-value ≤0.80 represented an abnormal test result. Patients with FFR_CT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFR_CT), all vessels with FFR_CT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFR_CT) ≥1 vessels with FFR_CT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. Results: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFR_CT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFR_CT ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFR_CT (n = 135) was similar to patients with FFR_CT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFR_CT (n = 90) and non-revascularized patients with FFR_CT ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. Conclusion: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFR_CT provides information regarding risk of recurrent angina.

Original language	English
Journal	Journal of Cardiovascular Computed Tomography
Volume	18
Issue number	3
Pages (from-to)	243-250
ISSN	1934-5925
DOIs	https://doi.org/10.1016/j.jcct.2024.01.010
Publication status	Published - 1. May 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Keywords

Angina
Complete revascularization
Coronary computed tomography angiography
Coronary revascularization
FFR
Recurrent angina
Stable angina pectoris
Predictive Value of Tests
Recurrence
Prognosis
Follow-Up Studies
Angina, Stable/physiopathology
Humans
Middle Aged
Male
Coronary Stenosis/diagnostic imaging
Time Factors
Female
Severity of Illness Index
Risk Assessment
Risk Factors
Computed Tomography Angiography
Coronary Angiography
Fractional Flow Reserve, Myocardial
Aged
Coronary Vessels/diagnostic imaging

Documents & Links

10.1016/j.jcct.2024.01.010Licence: CC BY-NC-ND

Open Access VersionFinal published version, 1.25 MBLicence: CC BY-NC-ND

SDU Link

Check access to the material in SDU Library's search engine

1 Ph.D. thesis

Recurrent Angina and Prognosis after Coronary Computed Tomography Angiography: Associations with FFR_CT and Coronary Plaque Characteristics -A 3-Year follow-up in Patients with Stable Angina
Madsen, K. T., 17. Apr 2024, Syddansk Universitet. Det Sundhedsvidenskabelige Fakultet. 147 p.
Research output: Thesis › Ph.D. thesis

Open Access
File
385 Downloads (Pure)

Cite this

Madsen, K. T., Nørgaard, B. L., Øvrehus, K. A., Jensen, J. M., Parner, E., Grove, E. L., Mortensen, M. B., Fairbairn, T. A., Nieman, K., Patel, M. R., Rogers, C., Mullen, S., Mickley, H., Thomsen, K. K., Bøtker, H. E., Leipsic, J., & Sand, N. P. R. (2024). Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study. Journal of Cardiovascular Computed Tomography, 18(3), 243-250. https://doi.org/10.1016/j.jcct.2024.01.010

@article{a050f31c2a9e4b56ba4079cee2d79187,

title = "Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study",

abstract = "Background: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFRCT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. Methods: Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFRCT-value ≤0.80 represented an abnormal test result. Patients with FFRCT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFRCT) ≥1 vessels with FFRCT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. Results: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFRCT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFRCT ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFRCT (n = 135) was similar to patients with FFRCT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFRCT (n = 90) and non-revascularized patients with FFRCT ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. Conclusion: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFRCT provides information regarding risk of recurrent angina.",

keywords = "Angina, Complete revascularization, Coronary computed tomography angiography, Coronary revascularization, FFR, Recurrent angina, Stable angina pectoris, Predictive Value of Tests, Recurrence, Prognosis, Follow-Up Studies, Angina, Stable/physiopathology, Humans, Middle Aged, Male, Coronary Stenosis/diagnostic imaging, Time Factors, Female, Severity of Illness Index, Risk Assessment, Risk Factors, Computed Tomography Angiography, Coronary Angiography, Fractional Flow Reserve, Myocardial, Aged, Coronary Vessels/diagnostic imaging",

author = "Madsen, {Kristian T{\ae}kker} and N{\o}rgaard, {Bjarne Linde} and {\O}vrehus, {Kristian Altern} and Jensen, {Jesper M{\o}ller} and Erik Parner and Grove, {Erik Lerkevang} and Mortensen, {Martin B.} and Fairbairn, {Timothy A.} and Koen Nieman and Patel, {Manesh R.} and Campbell Rogers and Sarah Mullen and Hans Mickley and Thomsen, {Kristian Korsgaard} and B{\o}tker, {Hans Erik} and Jonathon Leipsic and Sand, {Niels Peter R{\o}nnow}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = may,

day = "1",

doi = "10.1016/j.jcct.2024.01.010",

language = "English",

volume = "18",

pages = "243--250",

journal = "Journal of Cardiovascular Computed Tomography",

issn = "1934-5925",

publisher = "Elsevier",

number = "3",

}

Madsen, KT, Nørgaard, BL, Øvrehus, KA, Jensen, JM, Parner, E, Grove, EL, Mortensen, MB, Fairbairn, TA, Nieman, K, Patel, MR, Rogers, C, Mullen, S, Mickley, H, Thomsen, KK, Bøtker, HE, Leipsic, J & Sand, NPR 2024, 'Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study', Journal of Cardiovascular Computed Tomography, vol. 18, no. 3, pp. 243-250. https://doi.org/10.1016/j.jcct.2024.01.010

Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study. / Madsen, Kristian Tækker; Nørgaard, Bjarne Linde; Øvrehus, Kristian Altern et al.
In: Journal of Cardiovascular Computed Tomography, Vol. 18, No. 3, 01.05.2024, p. 243-250.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina

T2 - A 3-year follow-up study

AU - Madsen, Kristian Tækker

AU - Nørgaard, Bjarne Linde

AU - Øvrehus, Kristian Altern

AU - Jensen, Jesper Møller

AU - Parner, Erik

AU - Grove, Erik Lerkevang

AU - Mortensen, Martin B.

AU - Fairbairn, Timothy A.

AU - Nieman, Koen

AU - Patel, Manesh R.

AU - Rogers, Campbell

AU - Mullen, Sarah

AU - Mickley, Hans

AU - Thomsen, Kristian Korsgaard

AU - Bøtker, Hans Erik

AU - Leipsic, Jonathon

AU - Sand, Niels Peter Rønnow

PY - 2024/5/1

Y1 - 2024/5/1

N2 - Background: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFRCT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. Methods: Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFRCT-value ≤0.80 represented an abnormal test result. Patients with FFRCT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFRCT) ≥1 vessels with FFRCT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. Results: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFRCT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFRCT ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFRCT (n = 135) was similar to patients with FFRCT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFRCT (n = 90) and non-revascularized patients with FFRCT ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. Conclusion: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFRCT provides information regarding risk of recurrent angina.

AB - Background: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFRCT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. Methods: Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFRCT-value ≤0.80 represented an abnormal test result. Patients with FFRCT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFRCT) ≥1 vessels with FFRCT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. Results: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFRCT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFRCT ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFRCT (n = 135) was similar to patients with FFRCT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFRCT (n = 90) and non-revascularized patients with FFRCT ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. Conclusion: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFRCT provides information regarding risk of recurrent angina.

KW - Angina

KW - Complete revascularization

KW - Coronary computed tomography angiography

KW - Coronary revascularization

KW - FFR

KW - Recurrent angina

KW - Stable angina pectoris

KW - Predictive Value of Tests

KW - Recurrence

KW - Prognosis

KW - Follow-Up Studies

KW - Angina, Stable/physiopathology

KW - Humans

KW - Middle Aged

KW - Male

KW - Coronary Stenosis/diagnostic imaging

KW - Time Factors

KW - Female

KW - Severity of Illness Index

KW - Risk Assessment

KW - Risk Factors

KW - Computed Tomography Angiography

KW - Coronary Angiography

KW - Fractional Flow Reserve, Myocardial

KW - Aged

KW - Coronary Vessels/diagnostic imaging

U2 - 10.1016/j.jcct.2024.01.010

DO - 10.1016/j.jcct.2024.01.010

M3 - Journal article

C2 - 38246785

AN - SCOPUS:85183010880

SN - 1934-5925

VL - 18

SP - 243

EP - 250

JO - Journal of Cardiovascular Computed Tomography

JF - Journal of Cardiovascular Computed Tomography

IS - 3

ER -

Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study

Abstract

Bibliographical note

Keywords

Documents & Links

SDU Link

Fingerprint

Related research output

Recurrent Angina and Prognosis after Coronary Computed Tomography Angiography: Associations with FFRCT and Coronary Plaque Characteristics -A 3-Year follow-up in Patients with Stable Angina

Cite this

Recurrent Angina and Prognosis after Coronary Computed Tomography Angiography: Associations with FFR_CT and Coronary Plaque Characteristics -A 3-Year follow-up in Patients with Stable Angina