Literature DB >> 33762365

NHS England-funded CT fractional flow reserve in the era of the ISCHEMIA trial.

Hazhee Rasoul1, Saad Fyyaz2, Daniela Noakes1, Carl Shakespeare1, Sarojini David1, Zeeshan M Khawaja1, Nikolaos Papamichail1, Khaled Alfakih3.   

Abstract

BACKGROUND: The National Institute for Health and Care Excellence (NICE) 2016 guidelines (CG95) recommend patients with new stable chest pain be investigated with computed tomography coronary angiography (CTCA). An updated guideline (MTG32) recommended using CT fractional flow reserve (CTFFR) as a gatekeeper to invasive coronary angiography (ICA) for patients with coronary stenosis on CTCA. Subsequently, NHS England negotiated a UK-wide contract with HeartFlow, the provider of CTFFR. We describe our experience with CTFFR and consider the impact of the recent ISCHEMIA trial on these guidelines.
METHODS: We prospectively collected ICA and revascularisation data on all patients undergoing CTFFR from January 2019 to March 2020.
RESULTS: One-hundred and twenty-five of 140 patients completed CTFFR analysis. Eighty-one patients had CTCA stenosis >50%. Thirty-six had positive CTFFR; 29 underwent ICA with 22 (75.9%) revascularised. Forty-five had negative CTFFR; 14 underwent ICA and four (28.6%) were revascularised. The average cost of investigation per patient (PP) was £971.95. Had these patients undergone ICA directly with no functional test after CTCA, the average cost would be £932.51 PP.
CONCLUSION: Our revascularisation rates suggest that CTFFR can potentially be a gatekeeper to ICA but does not necessarily yield cost savings. © Royal College of Physicians 2021. All rights reserved.

Entities:  

Keywords:  CT coronary angiography; CT fractional flow reserve; audit; guidelines; stable chest pain

Mesh：

Year:  2021        PMID： 33762365      PMCID： PMC8002775          DOI： 10.7861/clinmed.2020-0691

Source DB:  PubMed          Journal:  Clin Med (Lond)        ISSN： 1470-2118            Impact factor:   2.659


  15 in total

1.  2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.

Authors:  Gilles Montalescot; Udo Sechtem; Stephan Achenbach; Felicita Andreotti; Chris Arden; Andrzej Budaj; Raffaele Bugiardini; Filippo Crea; Thomas Cuisset; Carlo Di Mario; J Rafael Ferreira; Bernard J Gersh; Anselm K Gitt; Jean-Sebastien Hulot; Nikolaus Marx; Lionel H Opie; Matthias Pfisterer; Eva Prescott; Frank Ruschitzka; Manel Sabaté; Roxy Senior; David Paul Taggart; Ernst E van der Wall; Christiaan J M Vrints; Jose Luis Zamorano; Stephan Achenbach; Helmut Baumgartner; Jeroen J Bax; Héctor Bueno; Veronica Dean; Christi Deaton; Cetin Erol; Robert Fagard; Roberto Ferrari; David Hasdai; Arno W Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Patrizio Lancellotti; Ales Linhart; Petros Nihoyannopoulos; Massimo F Piepoli; Piotr Ponikowski; Per Anton Sirnes; Juan Luis Tamargo; Michal Tendera; Adam Torbicki; William Wijns; Stephan Windecker; Juhani Knuuti; Marco Valgimigli; Héctor Bueno; Marc J Claeys; Norbert Donner-Banzhoff; Cetin Erol; Herbert Frank; Christian Funck-Brentano; Oliver Gaemperli; José R Gonzalez-Juanatey; Michalis Hamilos; David Hasdai; Steen Husted; Stefan K James; Kari Kervinen; Philippe Kolh; Steen Dalby Kristensen; Patrizio Lancellotti; Aldo Pietro Maggioni; Massimo F Piepoli; Axel R Pries; Francesco Romeo; Lars Rydén; Maarten L Simoons; Per Anton Sirnes; Ph Gabriel Steg; Adam Timmis; William Wijns; Stephan Windecker; Aylin Yildirir; Jose Luis Zamorano
Journal:  Eur Heart J       Date:  2013-08-30       Impact factor: 29.983

2.  Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study.

Authors:  W Bob Meijboom; Matthijs F L Meijs; Joanne D Schuijf; Maarten J Cramer; Nico R Mollet; Carlos A G van Mieghem; Koen Nieman; Jacob M van Werkhoven; Gabija Pundziute; Annick C Weustink; Alexander M de Vos; Francesca Pugliese; Benno Rensing; J Wouter Jukema; Jeroen J Bax; Mathias Prokop; Pieter A Doevendans; Myriam G M Hunink; Gabriel P Krestin; Pim J de Feyter
Journal:  J Am Coll Cardiol       Date:  2008-12-16       Impact factor: 24.094

Review 3.  CT-Derived Fractional Flow Reserve (CT-FFR) in the Evaluation of Coronary Artery Disease.

Authors:  Nancy Khav; Abdul Rahman Ihdayhid; Brian Ko
Journal:  Heart Lung Circ       Date:  2020-06-27       Impact factor: 2.975

4.  Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Authors:  David J Maron; Judith S Hochman; Harmony R Reynolds; Sripal Bangalore; Sean M O'Brien; William E Boden; Bernard R Chaitman; Roxy Senior; Jose López-Sendón; Karen P Alexander; Renato D Lopes; Leslee J Shaw; Jeffrey S Berger; Jonathan D Newman; Mandeep S Sidhu; Shaun G Goodman; Witold Ruzyllo; Gilbert Gosselin; Aldo P Maggioni; Harvey D White; Balram Bhargava; James K Min; G B John Mancini; Daniel S Berman; Michael H Picard; Raymond Y Kwong; Ziad A Ali; Daniel B Mark; John A Spertus; Mangalath N Krishnan; Ahmed Elghamaz; Nagaraja Moorthy; Whady A Hueb; Marcin Demkow; Kreton Mavromatis; Olga Bockeria; Jesus Peteiro; Todd D Miller; Hanna Szwed; Rolf Doerr; Matyas Keltai; Joseph B Selvanayagam; P Gabriel Steg; Claes Held; Shun Kohsaka; Stavroula Mavromichalis; Ruth Kirby; Neal O Jeffries; Frank E Harrell; Frank W Rockhold; Samuel Broderick; T Bruce Ferguson; David O Williams; Robert A Harrington; Gregg W Stone; Yves Rosenberg
Journal:  N Engl J Med       Date:  2020-03-30       Impact factor: 91.245

5.  Computed tomography coronary angiography: Diagnostic yield and downstream testing.

Authors:  Saad Fyyaz; Jonathan Hudson; Olaolu Olabintan; Athanasios Katsigris; Sarojini David; Sven Plein; Khaled Alfakih
Journal:  Clin Med (Lond)       Date:  2020-01       Impact factor: 2.659

6.  Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps).

Authors:  Bjarne L Nørgaard; Jonathon Leipsic; Sara Gaur; Sujith Seneviratne; Brian S Ko; Hiroshi Ito; Jesper M Jensen; Laura Mauri; Bernard De Bruyne; Hiram Bezerra; Kazuhiro Osawa; Mohamed Marwan; Christoph Naber; Andrejs Erglis; Seung-Jung Park; Evald H Christiansen; Anne Kaltoft; Jens F Lassen; Hans Erik Bøtker; Stephan Achenbach
Journal:  J Am Coll Cardiol       Date:  2014-01-30       Impact factor: 24.094

Review 7.  Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.

Authors:  George Cm Siontis; Dimitris Mavridis; John P Greenwood; Bernadette Coles; Adriani Nikolakopoulou; Peter Jüni; Georgia Salanti; Stephan Windecker
Journal:  BMJ       Date:  2018-02-21

Review 8.  Opportunities and challenges of implementing computed tomography fractional flow reserve into clinical practice.

Authors:  Muhummad Sohaib Nazir; Tarun K Mittal; Jonathan Weir-McCall; Koen Nieman; Keith Channon; Edward D Nicol
Journal:  Heart       Date:  2020-06-19       Impact factor: 5.994

9.  Fractional flow reserve (FFR) versus angiography in guiding management to optimise outcomes in non-ST segment elevation myocardial infarction (FAMOUS-NSTEMI) developmental trial: cost-effectiveness using a mixed trial- and model-based methods.

Authors:  Julian Nam; Andrew Briggs; Jamie Layland; Keith G Oldroyd; Nick Curzen; Arvind Sood; Kanarath Balachandran; Raj Das; Shahid Junejo; Hany Eteiba; Mark C Petrie; Mitchell Lindsay; Stuart Watkins; Simon Corbett; Brian O'Rourke; Anna O'Donnell; Andrew Stewart; Andrew Hannah; Alex McConnachie; Robert Henderson; Colin Berry
Journal:  Cost Eff Resour Alloc       Date:  2015-11-14

10.  Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE Registry.

Authors:  Timothy A Fairbairn; Koen Nieman; Takashi Akasaka; Bjarne L Nørgaard; Daniel S Berman; Gilbert Raff; Lynne M Hurwitz-Koweek; Gianluca Pontone; Tomohiro Kawasaki; Niels Peter Sand; Jesper M Jensen; Tetsuya Amano; Michael Poon; Kristian Øvrehus; Jeroen Sonck; Mark Rabbat; Sarah Mullen; Bernard De Bruyne; Campbell Rogers; Hitoshi Matsuo; Jeroen J Bax; Jonathon Leipsic; Manesh R Patel
Journal:  Eur Heart J       Date:  2018-11-01       Impact factor: 29.983
View more
  1 in total

1.  Diagnostic performance of coronary computed tomography angiography-derived fractional flow reverse in lesion-specific ischemia patients with different Gensini score levels.

Authors:  Mengya Dong; Chen Li; Guang Yang; Qiling Gou; Qinghua Zhao; Yuqi Liu; Xiling Shou
Journal:  Ann Transl Med       Date:  2022-04
  1 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.