Coronary CT angiography derived FFR in patients with left main disease
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Coronary CT angiography derived FFR in patients with left main disease. / Riedl, Katharina A; Jensen, Jesper M; Ko, Brian S; Leipsic, Jonathon; Grove, Erik Lerkevang; Mathiassen, Ole N; Bøtker, Hans Erik; Nørgaard, Bjarne L.
in: INT J CARDIOVAS IMAG, Jahrgang 37, Nr. 11, 11.2021, S. 3299-3308.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Coronary CT angiography derived FFR in patients with left main disease
AU - Riedl, Katharina A
AU - Jensen, Jesper M
AU - Ko, Brian S
AU - Leipsic, Jonathon
AU - Grove, Erik Lerkevang
AU - Mathiassen, Ole N
AU - Bøtker, Hans Erik
AU - Nørgaard, Bjarne L
N1 - © 2021. The Author(s).
PY - 2021/11
Y1 - 2021/11
N2 - The presence of left main coronary artery disease (LMCAD) is associated with an unfavorable clinical outcome. The clinical utility of FFRCT testing for non-invasive physiological assessment in LMCAD remains largely unknown. In this single center observational study LMCAD patients were retrospectively identified between November 2015 and December 2017. We evaluated the relationship between LMCAD diameter stenosis and downstream FFRCT values, and the clinical consequences following FFRCT testing in patients with LMCAD. The composite endpoint (all-cause death, myocardial infarction, unplanned revascularization) was determined over a median follow-up of 1.1 years. LMCAD was registered in 432 of 3202 (13%) patients having coronary CTA. FFRCT was prescribed in 213 (49%), while 59 (14%) patients were referred directly to invasive angiography or myocardial perfusion imaging. FFRCT was performed in 195 (45%) patients. LM stenosis severity was inversely related to downstream FFRCT values. In patients with simple LMCAD with stenosis ≥ 50%, > 80% had FFRCT > 0.80 in non-diseased proximal and downstream segments (n = 7). No patients with simple LMCAD and FFRCT > 0.80 (n = 20) suffered an adverse clinical outcome. FFRCT testing in patients with LMCAD is feasible. LM stenosis severity is inversely related to FFRCT value. Patients with LMCAD and FFRCT > 0.80 have favorable clinical outcomes at short-term follow-up. Large-scale studies assessing the clinical utility and safety of deferring invasive catheterization following FFRCT testing in patients with LMCAD are warranted.
AB - The presence of left main coronary artery disease (LMCAD) is associated with an unfavorable clinical outcome. The clinical utility of FFRCT testing for non-invasive physiological assessment in LMCAD remains largely unknown. In this single center observational study LMCAD patients were retrospectively identified between November 2015 and December 2017. We evaluated the relationship between LMCAD diameter stenosis and downstream FFRCT values, and the clinical consequences following FFRCT testing in patients with LMCAD. The composite endpoint (all-cause death, myocardial infarction, unplanned revascularization) was determined over a median follow-up of 1.1 years. LMCAD was registered in 432 of 3202 (13%) patients having coronary CTA. FFRCT was prescribed in 213 (49%), while 59 (14%) patients were referred directly to invasive angiography or myocardial perfusion imaging. FFRCT was performed in 195 (45%) patients. LM stenosis severity was inversely related to downstream FFRCT values. In patients with simple LMCAD with stenosis ≥ 50%, > 80% had FFRCT > 0.80 in non-diseased proximal and downstream segments (n = 7). No patients with simple LMCAD and FFRCT > 0.80 (n = 20) suffered an adverse clinical outcome. FFRCT testing in patients with LMCAD is feasible. LM stenosis severity is inversely related to FFRCT value. Patients with LMCAD and FFRCT > 0.80 have favorable clinical outcomes at short-term follow-up. Large-scale studies assessing the clinical utility and safety of deferring invasive catheterization following FFRCT testing in patients with LMCAD are warranted.
KW - Computed Tomography Angiography
KW - Coronary Angiography
KW - Coronary Artery Disease/diagnostic imaging
KW - Coronary Stenosis/diagnostic imaging
KW - Coronary Vessels/diagnostic imaging
KW - Fractional Flow Reserve, Myocardial
KW - Humans
KW - Predictive Value of Tests
KW - Retrospective Studies
KW - Severity of Illness Index
KW - Tomography, X-Ray Computed
U2 - 10.1007/s10554-021-02371-4
DO - 10.1007/s10554-021-02371-4
M3 - SCORING: Journal article
C2 - 34383150
VL - 37
SP - 3299
EP - 3308
JO - INT J CARDIOVAS IMAG
JF - INT J CARDIOVAS IMAG
SN - 1569-5794
IS - 11
ER -