Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFR(CT): outcome and resource impacts study

European Heart Journal
Pamela S DouglasPLATFORM Investigators

Abstract

In symptomatic patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) improves patient selection for invasive coronary angiography (ICA) compared with functional testing. The impact of measuring fractional flow reserve by CTA (FFRCT) is unknown. At 11 sites, 584 patients with new onset chest pain were prospectively assigned to receive either usual testing (n = 287) or CTA/FFR(CT) (n = 297). Test interpretation and care decisions were made by the clinical care team. The primary endpoint was the percentage of those with planned ICA in whom no significant obstructive CAD (no stenosis ≥50% by core laboratory quantitative analysis or invasive FFR < 0.80) was found at ICA within 90 days. Secondary endpoints including death, myocardial infarction, and unplanned revascularization were independently and blindly adjudicated. Subjects averaged 61 ± 11 years of age, 40% were female, and the mean pre-test probability of obstructive CAD was 49 ± 17%. Among those with intended ICA (FFR(CT)-guided = 193; usual care = 187), no obstructive CAD was found at ICA in 24 (12%) in the CTA/FFR(CT) arm and 137 (73%) in the usual care arm (risk difference 61%, 95% confidence interval 53-69, P< 0.0001), with similar ...Continue Reading

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Citations

Jan 20, 2016·Current Cardiology Reports·Mhairi Doris, David E Newby
Jan 21, 2016·European Heart Journal·Gianluca Pontone
Jan 5, 2016·European Heart Journal·Oliver GaemperliJeroen J Bax
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Mar 21, 2018·Radiology·Jonathon A Leipsic, Lynne Hurwitz Koweek

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Methods Mentioned

BETA
coronary artery bypass

Clinical Trials Mentioned

NCT01943903

Software Mentioned

HEART
PLATFORM
QAngio
PROMISE
HeartFlow
SAS

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