Jesper Møller Jensen

Influence of intensive lipid-lowering on CT derived fractional flow reserve in patients with stable chest pain: Rationale and design of the FLOWPROMOTE study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


  • Martin B Mortensen
  • Niels-Peter Sand, Hospital of Southwestern Jutland
  • ,
  • Martin Busk, University of Southern Denmark
  • ,
  • Jesper M Jensen
  • Erik L Grove
  • Damini Dey, Cedars-Sinai Medical Center
  • ,
  • Nadia Iraqi
  • Adam Updegrove, Heartflow Inc.
  • ,
  • Tim Fonte, Heartflow Inc.
  • ,
  • Ole N Mathiassen, Aarhus University
  • ,
  • Susanne Hosbond, University of Southern Denmark
  • ,
  • Hans E Bøtker
  • Jonathon Leipsic, St. Paul's Hospital Taoyuan
  • ,
  • Jagat Narula, Icahn School of Medicine at Mount Sinai
  • ,
  • Bjarne L Nørgaard

INTRODUCTION: Coronary CT angiography (CTA) derived fractional flow reserve (FFRCT ) shows high diagnostic performance when compared to invasively measured FFR. Presence and extent of low attenuation plaque density have been shown to be associated with abnormal physiology by measured FFR. Moreover, it is well established that statin therapy reduces the rate of plaque progression and results in morphology alterations underlying atherosclerosis. However, the interplay between lipid lowering treatment, plaque regression, and the coronary physiology has not previously been investigated.

AIM: To test whether lipid lowering therapy is associated with significant improvement in FFRCT , and whether there is a dose-response relationship between lipid lowering intensity, plaque regression, and coronary flow recovery.

METHODS: Investigator driven, prospective, multicenter, randomized study of patients with stable angina, coronary stenosis ≥50% determined by clinically indicated first-line CTA, and FFRCT  ≤ 0.80 in whom coronary revascularization was deferred. Patients are randomized to standard (atorvastatin 40 mg daily) or intensive (rosuvastatin 40 mg + ezetimibe 10 mg daily) lipid lowering therapy for 18 months. Coronary CTA scans with blinded coronary plaque and FFRCT analyses will be repeated after 9 and 18 months. The primary endpoint is the 18-month difference in FFRCT using (1) the FFRCT value 2 cm distal to stenosis and (2) the lowest distal value in the vessel of interest. A total of 104 patients will be included in the study.

CONCLUSION: The results of this study will provide novel insights into the interplay between lipid lowering, and the pathophysiology in coronary artery disease.

Original languageEnglish
JournalClinical Cardiology
Pages (from-to)986-994
Number of pages9
Publication statusPublished - Oct 2022

    Research areas

  • angina, coronary artery disease, fractional flow reserve, imaging, lipid lowering, statins, testing

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