First single-center experience with on-line FFRct in clinical assessment of stable chest pain

摘要

Purpose: CT derived FFR (FFRct) could potentially have an additional value to coronary CT angiography (CCTA) in the diagnostic and therapeutic decision making of patients who are evaluated for coronary artery disease (CAD). We retrospectively evaluated our first single-center experience with FFRct in the clinical assessment of stable chest pain. Methods: Since February 2016, on-line FFRct computation were performed by a third party (HeartFlow Inc., Redwood City, California, USA) when the CCTA showed a stenosis >40% in any coronary artery and if no severe artefacts were present. We retrospectively defined that FFRct analysis could contribute to the final diagnostic decision making when the clinical presentation and CCTA outcome are contradictive or inconclusive. Secondly, we reviewed the CCTA outcome with the result of the FFRct analysis and assessed the potential impact of the FFRct analysis on medical management. Results: Between February 2016 and July 2017, 65 FFRct analysis were performed. We concluded that the FFRct analysis had a potential value in the final diagnostic decision making of 32 patients (49%) due to a presentation of non-anginal complaints with a stenosis >50% (n=18), typical angina with a 40-50% stenosis (n=4) or inconclusive CCTA results (n=10). Additionally, we concluded that the medical management of 23 patients (35%) could have been different if the FFRct was considered in the diagnostic work-up. Conclusion: We conclude that FFRct has an additional value to CCTA in the clinical assessment of our patients with suspected CAD, especially in patients in which clinical presentation and CCTA outcome are not completely corresponding