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- Title
Computed tomography derived fractional flow reserve testing in stable patients with typical angina pectoris: influence on downstreamrate of invasive coronary angiography.
- Authors
Jensen, Jesper Møller; Bøtker, Hans Erik; Mathiassen, Ole Norling; Grove, Erik Lerkevang; Øvrehus, Kristian Altern; Pedersen, Kamilla Bech; Terkelsen, Christian Juhl; Christiansen, Evald Høj; Maeng, Michael; Leipsic, Jonathon; Kaltoft, Anne; Jakobsen, Lars; Sørensen, Jacob Thorsted; Thim, Troels; Kristensen, Steen Dalby; Krusell, Lars Romer; Nørgaard, Bjarne Linde
- Abstract
To assess the use of downstream coronary angiography (ICA) and short-term safety of frontline coronary CT angiography (CTA) with selective CT-derived fractional flow reserve (FFRCT) testing in stable patients with typical angina pectoris. Methods and results: Between 1 January 2016 and 30 June 2016 all patients (N = 774) referred to non-emergent ICA or coronary CTA at Aarhus University Hospital on a suspicion of CAD had frontline CTA performed. Downstream testing and treatment within 3 months and adverse events ≥90 days were registered. Patients were divided into two groups according to the presence of typical angina pectoris, which according to local practice would have resulted in referral to ICA, (low-intermediate-risk, n = 593 [76%]; high-risk, n = 181 [24%]) with mean pre-test probability of CAD of 31 ± 16% and 67 ± 16%, respectively. Coronary CTA was performed in 745 (96%) patients in whom FFRCT was prescribed in 212 (28%) patients. In the high- vs. low-intermediate-risk group, ICA was cancelled in 75% vs. 91%. Coronary revascularization was performed more frequently in high-risk than in low-intermediate-risk patients, 76% vs. 52% (P = 0.03). Mean follow-up time was 157 ± 50 days. Serious clinical events occurred in four patients, but not in any patients with cancelled ICA by coronary CTA with selective FFRCT testing. Conclusion: Frontline coronary CTA with selective FFRCT testing in stable patients with typical angina pectoris in real-world practice is associated with a high rate of safe cancellation of planned ICAs.
- Subjects
CORONARY disease; DIAGNOSIS; ANGINA pectoris; COMPUTED tomography; CORONARY circulation; MYOCARDIAL revascularization; PATIENT safety; OPERATIVE surgery; PRE-tests &; post-tests; TREATMENT duration; CORONARY angiography
- Publication
European Heart Journal - Cardiovascular Imaging, 2018, Vol 19, Issue 4, p405
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jex068