Potential Impact of Noninvasive FFRct to Guide Therapy in Chest Pain Patients with Intermediate (50-70%) CTA Stenosis: Can It Reduce Cost, Risk and Radiation Exposure?

Research output: Chapter in Book/Report/Conference proceedingMeeting abstract (Book)

Abstract

PURPOSE Can utilization of FFRct reduce cost, risk and radiation exposure in symptomatic patients with 50-70% CTA stenosis by reducing the number of “unnecessary” ICA-FFR examinations ? METHOD AND MATERIALS Retrospective analysis of 48 patients with stable chest pain, positive exercise ECG and intermediate (50-70%) CTA stenosis who were referred for ICA and FFR examination. Blinded FFRct analysis. Determination of diagnostic accuracy of FFRct vs CTA using FFR as reference standard. Evaluation of potential impact of clinical adoption of FFRct to guide clinical decision making; “unnecessary” ICA-FFR examinations defined as FFR in all vessels >0.80. RESULTS FFRct had higher diagnostic accuracy than CTA (83% vs 29%) with higher PPV (69% vs 29%) and a sixfold reduction in false positives. Using invasive FFR-guided therapy, 34/48 patients (71%) had nonobstructive CAD (FFR >0.80) and were treated medically; 14 (29%) had FFR ≤0.80 and were revascularized (8 PCI, 6 CABG). There were no major adverse cardiac events. Use of a FFRct-guided strategy would have reduced “unnecessary” ICA-FFR procedures by 85%, thereby reducing the inherent risk of an invasive procedure. Assuming a cost of 1000€ per FFRct analysis, an overall cost reduction of 30% would have been achieved. Furthermore, radiation dose exposure would have been reduced by 63%, assuming an average dose of 2.1 mSv for CTA and 4.8 mSV for ICA. CONCLUSION Utilization of FFRct analysis in the evaluation of symptomatic patients with intermediate CTA stenosis may result in fewer “unnecessary” invasive ICA-FFR examinations with reduced costs, risks and radiation dose exposure. CLINICAL RELEVANCE/APPLICATION Utilization of FFRct analysis in the evaluation of symptomatic patients with intermediate CTA stenosis may result in fewer “unnecessary” invasive ICA-FFR examinations with significantly reduced costs, risks and radiation dose exposure.
Original languageEnglish
Title of host publicationRSNA 2016 Scientific program
Publication statusPublished - 2016
EventRadiological Society of North America 2016 Scientific Assembly and Annual Meeting - Chicago, United States
Duration: 27 Nov 20162 Dec 2016
http://archive.rsna.org/2016/16009761.html

Conference

ConferenceRadiological Society of North America 2016 Scientific Assembly and Annual Meeting
Country/TerritoryUnited States
CityChicago
Period27/11/162/12/16
Internet address

Bibliographical note

De Smet,K, Sonck,J, Belsack,D, Tanaka,K, Buls,N, De Mey,J, Potential Impact of Noninvasive FFRct to Guide Therapy in Chest Pain Patients with Intermediate (50-70%) CTA Stenosis: Can It Reduce Cost, Risk and Radiation Exposure?. Radiological Society of North America 2016 Scientific Assembly and Annual Meeting, November 27 - December 2, 2016, Chicago IL. archive.rsna.org/2016/16009761.html Accessed February 6, 2017

Fingerprint

Dive into the research topics of 'Potential Impact of Noninvasive FFRct to Guide Therapy in Chest Pain Patients with Intermediate (50-70%) CTA Stenosis: Can It Reduce Cost, Risk and Radiation Exposure?'. Together they form a unique fingerprint.

Cite this