1. Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina: A 3-year follow-up study.
- Author
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Madsen, Kristian Tækker, Nørgaard, Bjarne Linde, Øvrehus, Kristian Altern, Jensen, Jesper Møller, Parner, Erik, Grove, Erik Lerkevang, Mortensen, Martin B., Fairbairn, Timothy A., Nieman, Koen, Patel, Manesh R., Rogers, Campbell, Mullen, Sarah, Mickley, Hans, Thomsen, Kristian Korsgaard, Bøtker, Hans Erik, Leipsic, Jonathon, and Sand, Niels Peter Rønnow
- Abstract
The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFR CT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain. Multicenter 3-year follow-up study of patients presenting with symptoms suggestive of new onset SAP who underwent first-line CTA evaluation and subsequent standard-of-care treatment. All patients had at least one ≥30 % coronary stenosis. A per-patient lowest FFR CT -value ≤0.80 represented an abnormal test result. Patients with FFR CT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFR CT), all vessels with FFR CT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFR CT) ≥1 vessels with FFR CT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire. Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFR CT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFR CT ≤0.80 vs > 0.80 associated to increased risk of recurrent angina, relative risk (RR): 1.82; 95 % CI: 1.31–2.52, p < 0.001. Risk of recurrent angina in CR-FFR CT (n = 135) was similar to patients with FFR CT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62–1.40, p = 0.72, while IR-FFR CT (n = 90) and non-revascularized patients with FFR CT ≤0.80 (n = 285) had increased risk, 37 % vs 15 % RR: 2.50; 95 % CI: 1.68–3.73, p < 0.001 and 30 % vs 15 %, RR: 2.03; 95 % CI: 1.44–2.87, p < 0.001, respectively. Use of antianginal medication was similar across study groups. In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFR CT provides information regarding risk of recurrent angina. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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