Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina : A 3-year follow-up study
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..
BACKGROUND: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFRCT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain.
METHODS: 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 FFRCT-value ≤0.80 represented an abnormal test result. Patients with FFRCT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFRCT) ≥1 vessels with FFRCT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire.
RESULTS: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFRCT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFRCT ≤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-FFRCT (n = 135) was similar to patients with FFRCT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62-1.40, p = 0.72, while IR-FFRCT (n = 90) and non-revascularized patients with FFRCT ≤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.
CONCLUSION: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFRCT provides information regarding risk of recurrent angina.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of cardiovascular computed tomography - (2024) vom: 20. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Madsen, Kristian Tækker [VerfasserIn] |
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| Links: |
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| Themen: |
Angina |
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| Anmerkungen: |
Date Revised 21.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.jcct.2024.01.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367372797 |
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| 100 | 1 | |a Madsen, Kristian Tækker |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Coronary computed tomography angiography derived fractional flow reserve and risk of recurrent angina |b A 3-year follow-up study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 21.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The association between coronary computed tomography angiography (CTA) derived fractional flow reserve (FFRCT) and risk of recurrent angina in patients with new onset stable angina pectoris (SAP) and stenosis by CTA is uncertain | ||
| 520 | |a METHODS: 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 FFRCT-value ≤0.80 represented an abnormal test result. Patients with FFRCT ≤0.80 who underwent revascularization were categorized according to completeness of revascularization: 1) Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤0.80 revascularized; or 2) incompletely revascularized (IR-FFRCT) ≥1 vessels with FFRCT ≤0.80 non-revascularized. Recurrent angina was evaluated using the Seattle Angina Questionnaire | ||
| 520 | |a RESULTS: Amongst 769 patients (619 [80 %] stenosis ≥50 %, 510 [66 %] FFRCT ≤0.80), 174 (23 %) reported recurrent angina at follow-up. An FFRCT ≤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-FFRCT (n = 135) was similar to patients with FFRCT >0.80, 13 % vs 15 %, RR: 0.93; 95 % CI: 0.62-1.40, p = 0.72, while IR-FFRCT (n = 90) and non-revascularized patients with FFRCT ≤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 | ||
| 520 | |a CONCLUSION: In patients with SAP and coronary stenosis by CTA undergoing standard-of-care guided treatment, FFRCT provides information regarding risk of recurrent angina | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Angina | |
| 650 | 4 | |a Complete revascularization | |
| 650 | 4 | |a Coronary computed tomography angiography | |
| 650 | 4 | |a Coronary revascularization | |
| 650 | 4 | |a FFR(CT) | |
| 650 | 4 | |a Recurrent angina | |
| 650 | 4 | |a Stable angina pectoris | |
| 700 | 1 | |a Nørgaard, Bjarne Linde |e verfasserin |4 aut | |
| 700 | 1 | |a Øvrehus, Kristian Altern |e verfasserin |4 aut | |
| 700 | 1 | |a Jensen, Jesper Møller |e verfasserin |4 aut | |
| 700 | 1 | |a Parner, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Grove, Erik Lerkevang |e verfasserin |4 aut | |
| 700 | 1 | |a Mortensen, Martin B |e verfasserin |4 aut | |
| 700 | 1 | |a Fairbairn, Timothy A |e verfasserin |4 aut | |
| 700 | 1 | |a Nieman, Koen |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Manesh R |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers, Campbell |e verfasserin |4 aut | |
| 700 | 1 | |a Mullen, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Mickley, Hans |e verfasserin |4 aut | |
| 700 | 1 | |a Thomsen, Kristian Korsgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Bøtker, Hans Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Leipsic, Jonathon |e verfasserin |4 aut | |
| 700 | 1 | |a Sand, Niels Peter Rønnow |e verfasserin |4 aut | |
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