Bjarne Linde Nørgaard1, Jesper Møller Jensen2, Philipp Blanke3, Niels Peter Sand4, Mark Rabbat5, Jonathon Leipsic3. 1. Department Cardiology, Aarhus University Hospital, 8200, Aarhus N, Denmark. bnorgaard@dadlnet.dk. 2. Department Cardiology, Aarhus University Hospital, 8200, Aarhus N, Denmark. 3. Department of Radiology and Medicine, St. Paul´s Hospital, University of British Columbia, Vancouver, Canada. 4. Department Cardiology, Hospital of South West Denmark, Esbjerg, and Institute of regional Health Research, University of Southern Denmark, Esbjerg, Denmark. 5. Medicine and Radiology, Division of Cardiology, Loyola University Chicago, Chicago, Illinois, USA.
Abstract
PURPOSE OF REVIEW: To summarize the scientific basis of CT derived fractional flow reserve (FFRCT) and present an updated review on the evidence from clinical trials and real-world observational data RECENT FINDINGS: In prospective multicenter studies of patients with stable coronary artery disease (CAD), FFRCT showed high diagnostic performance. More recently, FFRCT has advanced to the realm of clinical utility and real-world clinical practice with emerging data showing that FFRCT when compared to standard care is efficient in safely reducing downstream utilization of invasive coronary angiography (ICA), and costs, as well as improving the diagnostic yield of ICA. Moreover, FFRCT may broaden applicability of frontline coronary CTA testing to patients with high pre-test risk of CAD. Introducing FFRCT into clinical practice has the potential to significantly improve the management of patients with stable CAD. The optimal FFRCT testing interpretation strategy, as well as the relative cost-efficiency of FFRCT against standard noninvasive functional testing, need further investigation.
PURPOSE OF REVIEW: To summarize the scientific basis of CT derived fractional flow reserve (FFRCT) and present an updated review on the evidence from clinical trials and real-world observational data RECENT FINDINGS: In prospective multicenter studies of patients with stable coronary artery disease (CAD), FFRCT showed high diagnostic performance. More recently, FFRCT has advanced to the realm of clinical utility and real-world clinical practice with emerging data showing that FFRCT when compared to standard care is efficient in safely reducing downstream utilization of invasive coronary angiography (ICA), and costs, as well as improving the diagnostic yield of ICA. Moreover, FFRCT may broaden applicability of frontline coronary CTA testing to patients with high pre-test risk of CAD. Introducing FFRCT into clinical practice has the potential to significantly improve the management of patients with stable CAD. The optimal FFRCT testing interpretation strategy, as well as the relative cost-efficiency of FFRCT against standard noninvasive functional testing, need further investigation.
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