Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences
Coronary CT angiography (CTA) derived fractional flow reserve (FFR CT ) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR CT...
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| Veröffentlicht in: | The international journal of cardiovascular imaging 2024-10, Vol.40 (10), p.2213-2220 |
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| creator | Thangavel, Shifan Madsen, Kristian Taekker Rønnow Sand, Niels Peter Veien, Karsten Tange Deibjerg, Lone Husain, Majed Hosbond, Susanne Alan, Dilek Hunerel Øvrehus, Kristian Altern Junker, Anders Mortensen, Jonas Thomsen, Kristian Korsgaard Jensen, Lisette Okkels Poulsen, Tina Svenstrup Steffensen, Flemming Hald Rohold, Allan Busk, Martin |
| description | Coronary CT angiography (CTA) derived fractional flow reserve (FFR
CT
) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR
CT
test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30–89%) by CTA. Evaluation of CTA datasets, interpretation of FFR
CT
analysis, and decisions on downstream testing were performed by skilled CT-cardiologists. CTA was performed in 3974 patients, of whom 381 (10%) were referred directly to ICA, whereas 463 (12%) to non-invasive functional testing: FFR
CT
375 (81%) and perfusion imaging 88 (19%). FFR
CT
analysis was rejected in 8 (2%) due to inadequate CTA image quality. Number of patients deferred from ICA after FFR
CT
was 267 (71%), while 100 (27%) were referred to ICA. Obstructive coronary artery disease (CAD) was confirmed in 62 (62%) patients and revascularization performed in 53 (53%). Revascularization rates, n (%), were higher in patients undergoing FFR
CT
-guided versus CTA-guided referral to ICA: 30–69% stenosis, 28 (44%) versus 8 (21%); 70–89% stenosis, 39 (69%) versus 25 (46%), respectively, both
p
|
| doi_str_mv | 10.1007/s10554-024-03214-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11499349</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3119814541</sourcerecordid><originalsourceid>FETCH-LOGICAL-c333t-c7c6ab584ea69f5863157212d07bc195b0a4140aa0b479c68328b3bb08f74a563</originalsourceid><addsrcrecordid>eNp9kd9KHDEUxkOxVGv7Al4NeOPNaE7-zCRXIotbC0KhtdchyZ7dRmYzYzKz2LfxWXyyRleseiEk5HDO7_tI8hFyAPQYKG1PMlApRU1Z2ZyBqNUHsgeqlbXiwHZe1Lvkc87XlELLtf5EdrlmUgve7BHzCzv0Y9hgNZ__nF1VI-YxxFUVYpWnPJQZLqo8WtdhZeMqRPsw8l2IwduuGpItao_3d_X9XemNoTTxdsAUMHrMX8jHpe0yfn0698nv-fnV7KK-_PHt--zssvac87H2rW-sk0qgbfRSqoaDbBmwBW2dBy0dtQIEtZY60WrfKM6U485RtWyFlQ3fJ6db32Fya1x4jGOynRlSWNv01_Q2mNeTGP6YVb8xAEJrLnRxOHpySP3NVH7BrEP22HU2Yj9lw4EypWhZBT18g173U4rlfYUCrUBIAYViW8qnPueEy-fbADUPAZptgKYEaB4DNKqI-FaUCxxXmP5bv6P6B1JwnhA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3119814541</pqid></control><display><type>article</type><title>Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences</title><source>SpringerNature Journals</source><creator>Thangavel, Shifan ; Madsen, Kristian Taekker ; Rønnow Sand, Niels Peter ; Veien, Karsten Tange ; Deibjerg, Lone ; Husain, Majed ; Hosbond, Susanne ; Alan, Dilek Hunerel ; Øvrehus, Kristian Altern ; Junker, Anders ; Mortensen, Jonas ; Thomsen, Kristian Korsgaard ; Jensen, Lisette Okkels ; Poulsen, Tina Svenstrup ; Steffensen, Flemming Hald ; Rohold, Allan ; Busk, Martin</creator><creatorcontrib>Thangavel, Shifan ; Madsen, Kristian Taekker ; Rønnow Sand, Niels Peter ; Veien, Karsten Tange ; Deibjerg, Lone ; Husain, Majed ; Hosbond, Susanne ; Alan, Dilek Hunerel ; Øvrehus, Kristian Altern ; Junker, Anders ; Mortensen, Jonas ; Thomsen, Kristian Korsgaard ; Jensen, Lisette Okkels ; Poulsen, Tina Svenstrup ; Steffensen, Flemming Hald ; Rohold, Allan ; Busk, Martin</creatorcontrib><description>Coronary CT angiography (CTA) derived fractional flow reserve (FFR
CT
) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR
CT
test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30–89%) by CTA. Evaluation of CTA datasets, interpretation of FFR
CT
analysis, and decisions on downstream testing were performed by skilled CT-cardiologists. CTA was performed in 3974 patients, of whom 381 (10%) were referred directly to ICA, whereas 463 (12%) to non-invasive functional testing: FFR
CT
375 (81%) and perfusion imaging 88 (19%). FFR
CT
analysis was rejected in 8 (2%) due to inadequate CTA image quality. Number of patients deferred from ICA after FFR
CT
was 267 (71%), while 100 (27%) were referred to ICA. Obstructive coronary artery disease (CAD) was confirmed in 62 (62%) patients and revascularization performed in 53 (53%). Revascularization rates, n (%), were higher in patients undergoing FFR
CT
-guided versus CTA-guided referral to ICA: 30–69% stenosis, 28 (44%) versus 8 (21%); 70–89% stenosis, 39 (69%) versus 25 (46%), respectively, both
p
< 0.05. Implementation of FFR
CT
at referral hospitals was feasible, reduced the number of invasive procedures, and increased the revascularization rate.</description><identifier>ISSN: 1875-8312</identifier><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1875-8312</identifier><identifier>EISSN: 1573-0743</identifier><identifier>DOI: 10.1007/s10554-024-03214-8</identifier><identifier>PMID: 39259436</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Algorithms ; Angina ; Angiography ; Cardiac Imaging ; Cardiology ; Cardiovascular disease ; Computed tomography ; Coronary artery disease ; Feasibility studies ; Functional testing ; Heart diseases ; Hospitals ; Image processing ; Image quality ; Imaging ; Medical imaging ; Medicine ; Medicine & Public Health ; Original Paper ; Patients ; Radiology ; Stenosis</subject><ispartof>The international journal of cardiovascular imaging, 2024-10, Vol.40 (10), p.2213-2220</ispartof><rights>The Author(s) 2024</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c333t-c7c6ab584ea69f5863157212d07bc195b0a4140aa0b479c68328b3bb08f74a563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10554-024-03214-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10554-024-03214-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Thangavel, Shifan</creatorcontrib><creatorcontrib>Madsen, Kristian Taekker</creatorcontrib><creatorcontrib>Rønnow Sand, Niels Peter</creatorcontrib><creatorcontrib>Veien, Karsten Tange</creatorcontrib><creatorcontrib>Deibjerg, Lone</creatorcontrib><creatorcontrib>Husain, Majed</creatorcontrib><creatorcontrib>Hosbond, Susanne</creatorcontrib><creatorcontrib>Alan, Dilek Hunerel</creatorcontrib><creatorcontrib>Øvrehus, Kristian Altern</creatorcontrib><creatorcontrib>Junker, Anders</creatorcontrib><creatorcontrib>Mortensen, Jonas</creatorcontrib><creatorcontrib>Thomsen, Kristian Korsgaard</creatorcontrib><creatorcontrib>Jensen, Lisette Okkels</creatorcontrib><creatorcontrib>Poulsen, Tina Svenstrup</creatorcontrib><creatorcontrib>Steffensen, Flemming Hald</creatorcontrib><creatorcontrib>Rohold, Allan</creatorcontrib><creatorcontrib>Busk, Martin</creatorcontrib><title>Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences</title><title>The international journal of cardiovascular imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><description>Coronary CT angiography (CTA) derived fractional flow reserve (FFR
CT
) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR
CT
test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30–89%) by CTA. Evaluation of CTA datasets, interpretation of FFR
CT
analysis, and decisions on downstream testing were performed by skilled CT-cardiologists. CTA was performed in 3974 patients, of whom 381 (10%) were referred directly to ICA, whereas 463 (12%) to non-invasive functional testing: FFR
CT
375 (81%) and perfusion imaging 88 (19%). FFR
CT
analysis was rejected in 8 (2%) due to inadequate CTA image quality. Number of patients deferred from ICA after FFR
CT
was 267 (71%), while 100 (27%) were referred to ICA. Obstructive coronary artery disease (CAD) was confirmed in 62 (62%) patients and revascularization performed in 53 (53%). Revascularization rates, n (%), were higher in patients undergoing FFR
CT
-guided versus CTA-guided referral to ICA: 30–69% stenosis, 28 (44%) versus 8 (21%); 70–89% stenosis, 39 (69%) versus 25 (46%), respectively, both
p
< 0.05. Implementation of FFR
CT
at referral hospitals was feasible, reduced the number of invasive procedures, and increased the revascularization rate.</description><subject>Algorithms</subject><subject>Angina</subject><subject>Angiography</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Computed tomography</subject><subject>Coronary artery disease</subject><subject>Feasibility studies</subject><subject>Functional testing</subject><subject>Heart diseases</subject><subject>Hospitals</subject><subject>Image processing</subject><subject>Image quality</subject><subject>Imaging</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Radiology</subject><subject>Stenosis</subject><issn>1875-8312</issn><issn>1569-5794</issn><issn>1875-8312</issn><issn>1573-0743</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9kd9KHDEUxkOxVGv7Al4NeOPNaE7-zCRXIotbC0KhtdchyZ7dRmYzYzKz2LfxWXyyRleseiEk5HDO7_tI8hFyAPQYKG1PMlApRU1Z2ZyBqNUHsgeqlbXiwHZe1Lvkc87XlELLtf5EdrlmUgve7BHzCzv0Y9hgNZ__nF1VI-YxxFUVYpWnPJQZLqo8WtdhZeMqRPsw8l2IwduuGpItao_3d_X9XemNoTTxdsAUMHrMX8jHpe0yfn0698nv-fnV7KK-_PHt--zssvac87H2rW-sk0qgbfRSqoaDbBmwBW2dBy0dtQIEtZY60WrfKM6U485RtWyFlQ3fJ6db32Fya1x4jGOynRlSWNv01_Q2mNeTGP6YVb8xAEJrLnRxOHpySP3NVH7BrEP22HU2Yj9lw4EypWhZBT18g173U4rlfYUCrUBIAYViW8qnPueEy-fbADUPAZptgKYEaB4DNKqI-FaUCxxXmP5bv6P6B1JwnhA</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Thangavel, Shifan</creator><creator>Madsen, Kristian Taekker</creator><creator>Rønnow Sand, Niels Peter</creator><creator>Veien, Karsten Tange</creator><creator>Deibjerg, Lone</creator><creator>Husain, Majed</creator><creator>Hosbond, Susanne</creator><creator>Alan, Dilek Hunerel</creator><creator>Øvrehus, Kristian Altern</creator><creator>Junker, Anders</creator><creator>Mortensen, Jonas</creator><creator>Thomsen, Kristian Korsgaard</creator><creator>Jensen, Lisette Okkels</creator><creator>Poulsen, Tina Svenstrup</creator><creator>Steffensen, Flemming Hald</creator><creator>Rohold, Allan</creator><creator>Busk, Martin</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241001</creationdate><title>Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences</title><author>Thangavel, Shifan ; 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CT
) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR
CT
test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30–89%) by CTA. Evaluation of CTA datasets, interpretation of FFR
CT
analysis, and decisions on downstream testing were performed by skilled CT-cardiologists. CTA was performed in 3974 patients, of whom 381 (10%) were referred directly to ICA, whereas 463 (12%) to non-invasive functional testing: FFR
CT
375 (81%) and perfusion imaging 88 (19%). FFR
CT
analysis was rejected in 8 (2%) due to inadequate CTA image quality. Number of patients deferred from ICA after FFR
CT
was 267 (71%), while 100 (27%) were referred to ICA. Obstructive coronary artery disease (CAD) was confirmed in 62 (62%) patients and revascularization performed in 53 (53%). Revascularization rates, n (%), were higher in patients undergoing FFR
CT
-guided versus CTA-guided referral to ICA: 30–69% stenosis, 28 (44%) versus 8 (21%); 70–89% stenosis, 39 (69%) versus 25 (46%), respectively, both
p
< 0.05. Implementation of FFR
CT
at referral hospitals was feasible, reduced the number of invasive procedures, and increased the revascularization rate.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>39259436</pmid><doi>10.1007/s10554-024-03214-8</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | SpringerNature Journals |
| subjects | Algorithms Angina Angiography Cardiac Imaging Cardiology Cardiovascular disease Computed tomography Coronary artery disease Feasibility studies Functional testing Heart diseases Hospitals Image processing Image quality Imaging Medical imaging Medicine Medicine & Public Health Original Paper Patients Radiology Stenosis |
| title | Selective FFRCT testing in suspected stable angina in clinical practice - initial experiences |
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