Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry

To date, the clinical utility of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT) has been limited to trials and single center experiences. We herein report the incidence of abnormal FFRCT (≤0.80) and the relationship of lesion-specific ischemia to subject demographics, symptoms, and degree of stenosis in the multicenter, prospective ADVANCE registry. One thousand patients with suspected angina having documented coronary artery disease on coronary CTA and clinically referred for FFRCT were prospectively enrolled in the registry. Patient demographics, symptom status, coronary CTA and FFRCT findings were recorded. Univariate and multivariate analyses were performed to investigate the predictors related to abnormal FFRCT. FFRCT data were analyzed in 952 patients (95.2%). Overall, 51.1% patients had a positive FFRCT value (≤0.80). Patients with ≥3 risk factors had a significantly higher rate of abnormal FFRCT than those with 70% stenosis was significantly associated with low FFRCT (OR 31.16, 95%CI 12.25–79.22, p