1-Year cardiovascular outcomes of FFR-CT in suspected coronary artery disease

Abstract

Purpose: Computed tomography fractional flow reserve (FFR-CT) is a non-invasive method to estimate the fractional flow reserve (FFR) using images of coronary computed tomography angiography (CCTA). The aim of this study is to assess whether patients with suspected CAD evaluated with additional FFR-CT have similar or different rates of major adverse cardiac and cerebrovascular events (MACCE) compared to patients receiving no FFR-CT. Methods: In this single-center retrospective cohort study, patients who received CCTA followed by FFR-CT (FFR-CT group) and patients who received CCTA without FFR-CT before FFR-CT was available (CCTA group) were compared. Included patients had ≥1 anatomically significant stenosis on CCTA. Primary outcome was the rate of MACCE after one year. Secondary outcomes were invasive coronary angiography- (ICA) and revascularization rates. Hazard ratio (HR) for MACCE was calculated. Secondary outcomes were compared using the Pearson chi-square test. Results: A total of 360 participants (FFR-CT group n=136, CCTA group n=224, mean age 59.4 years, 52.8% men) were analyzed. The rate of MACCE was low (n=11 events in 10 participants(2.8%)) and consisted of myocardial infarctions (n=7) and strokes (n=4). MACCE rate in the FFR-CT group was not significantly different from the CCTA group (2.2% vs 3.1%) (HR 0.71, 95% confidence interval 0.18- 2.73, p=0.61). Significantly fewer ICAs as consequence of the CCTA were conducted in the FFR-CT group (19.9% vs 51.3%, p<0.001).