Jesper Møller Jensen

Computed tomography derived fractional flow reserve testing in stable patients with typical angina pectoris: influence on downstream rate of invasive coronary angiography

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Aims 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 (FFR CT) testing in stable patients with typical angina pectoris. Methods Between 1 January 2016 and 30 June 2016 all patients (N = 774) referred to non-emergent ICA or coronary CTA and results 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 FFR CT 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 FFR CT testing. Conclusion Frontline coronary CTA with selective FFR CT testing in stable patients with typical angina pectoris in real-world practice is associated with a high rate of safe cancellation of planned ICAs.

Original languageEnglish
JournalEuropean Heart Journal Cardiovascular Imaging
Pages (from-to)405-414
Number of pages10
Publication statusPublished - Apr 2018

    Research areas

  • stable angina, diagnostic testing, coronary ct angiography, fractional flow reserve, ARTERY-DISEASE, DIAGNOSTIC PERFORMANCE, CT ANGIOGRAPHY, NXT TRIAL, MULTICENTER, ACCURACY, STENOSES, OUTCOMES, HEART, Prospective Studies, Follow-Up Studies, Humans, Middle Aged, Male, Asymptomatic Diseases, Cause of Death, Female, Coronary Angiography/methods, Severity of Illness Index, Risk Assessment, Computed Tomography Angiography/methods, Hospitals, University, Survival Rate, Disease Progression, Angina Pectoris/diagnostic imaging, Fractional Flow Reserve, Myocardial/physiology, Aged, Cohort Studies

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