Computed Tomography-Derived Fractional Flow Reserve in Patients With Chronic Coronary Syndrome: A Real-World Cohort Study

Thomas Vedel Kvist, Bjarne Linde Nørgaard, Hans Erik Bøtker, Ole Norling Mathiassen, Erik Lerkevang Grove, Erik Parner, Jesper Møller Jensen

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OBJECTIVE: This study aimed to investigate the outcome of computed tomography (CT) angiography with optional CT-derived fractional flow reserve (FFRCT) of intermediate-range coronary artery disease in non-emergent patients referred on a suspicion of chronic coronary syndrome.

METHODS: Patients were classified as high risk and low-intermediate risk according to the presence of typical angina or either atypical or nonangina chest pain. Outcome was assessed as the cumulative incidence proportion of a composite end point of unstable angina pectoris, unplanned revascularization, nonfatal myocardial infarction, and all-cause mortality.

RESULTS: The study included 743 patients. Mean follow-up was 2.2 (range, 0.1-2.5) years. Low-intermediate-risk and high-risk patients who had invasive coronary angiography deferred had comparable proportions of adverse events (1.4% vs 2.6% [P = 0.27]). Adverse events in high-risk patients with FFRCT >0.80 was 3.3% versus 1.4% in patients where no additional testing was performed (P = 0.79).

CONCLUSIONS: Computed tomography-derived fractional flow reserve >0.8 conveys an excellent prognosis. Computed tomography angiography with optional FFRCT allows for the safe cancellation of invasive coronary angiography in high-risk patients.

Original languageEnglish
JournalJournal of Computer Assisted Tomography
Pages (from-to)408-414
Number of pages7
Publication statusPublished - May 2021


  • CT-derived fractional flow reserve
  • chronic coronary syndrome
  • coronary CT angiography
  • diagnostic testing
  • fractional flow reserve
  • stable angina


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