Diagnostic, therapeutic and economic implications of FFRCT-adoption in the non-invasive assessment of CAD: a retrospective study.

Aims and objectives: Large-scale registry data showed up to 60 % of patients with stable chest pain undergoing invasive coronary angiography (ICA) do not have obstructive coronary artery disease (CAD) (1). Fractional flow reserve by computed tomographic angiography (FFRCT, CTA) is a noninvasive method to determine haem[…]Methods and materials: 41 symptomatic patients (> 18 years, no cardiac history) with reported intermediate stenosis (50-70%) on CTA (Philips iCT – GE Revolution CT) and who underwent ICA-FFR, were retrospectively assigned to FFRCT. At Heartflow Inc., CTA images were segmented and analysed quantitatively. 3D Coronary […]Results: FFRCT-adoption significantly raises PPV for obstructive CAD from 29 % to 67 % compared to CTA within population of CTA-reported intermediate stenosis, by establishing a sixfold reduction in number of false positives. A CTA/FFRCT-strategy could realize a reduction of “unnecessary” invasive ICA-FFR-p[…]Conclusion: FFRCT is a new computational method which could become a noninvasive alternative to FFR in the assessment of intermediate stenosis, functioning as a gatekeeper for the cathlab with high diagnostic performance, thereby reducing cost, radiation dose and inherent risk for iatrogenic complications.Personal information: For further information, please contact: Dr. Kristof De Smet, MD, MSc Department of Radiology UZ Brussel (Brussels, Belgium) E [email protected]: (1) Patel MR, Peterson ED, Dai D et al (2010) Low diagnostic yield of elective coronary angiography. N Engl J Med 362:886–895. (2) Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing? Nørgaard BL, Jensen JM, Leipsic J. Eur[…]