Abnormal FFRCT test tied to recurrent chest pain: Study
Denmark: An abnormal fractional flow reserve CT (FFRCT) test result in patients with new-onset stable angina pectoris (SAP) is associated with an increased risk of recurrent chest pain (CP), finds a recent study. The study was published in the European Heart Journal - Cardiovascular Imaging on October 18, 2021.
The study was conducted with an objective to evaluate the association between coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) and recurrent chest pain at 1-year follow-up in patients with stable angina pectoris.
The study included patients (n = 267) with SAP who underwent CCTA and FFRCT testing; 236 (88%) underwent invasive coronary angiography, and 87 (33%) were revascularized. Through a structured interview, the researchers gathered symptomatic status at 1-year follow-up. Three different FFRCT algorithms were applied using the following criteria for abnormality: (i) 2 cm-FFRCT ≤0.80; (ii) d-FFRCT ≤0.80; and (iii) a combination in which both a d-FFRCT ≤0.80 and a ΔFFRCT ≥0.06 must be present in the same vessel (c-FFRCT).
Based on the FFRCT test result and revascularization, the patients were classified into two groups: 1) completely revascularized/normal (CRN) -- patients in whom all coronary arteries with an abnormal FFRCT test result were revascularized or patients with completely normal FFRCT test results; 2) incompletely revascularized (IR) -- patients in whom ≥1 coronary artery with an abnormal FFRCT test result was not revascularized.
Key findings include:
- Recurrent CP was present in 62 (23%) patients.
- Classification of patients (CRN or IR) was significantly associated with recurrent CP for all applied FFRCT interpretation algorithms.
- When applying the c-FFRCT algorithm, the association with recurrent CP was found, irrespective of the extent of coronary calcification and the degree of coronary stenosis.
- A negative association between per-patient minimal d-FFRCT and recurrent CP was demonstrated.
"This study is the first to indicate that an abnormal FFRCT test result can be associated with recurrent CP in patients with new-onset SAP," wrote the authors. "Classification of patients based on the FFRCT analysis was significantly associated with recurrent CP at 1-year follow-up."
Reference:
Kristian Tækker Madsen, Karsten Tange Veien, Pia Larsen, Majed Husain, Lone Deibjerg, Anders Junker, Martin Weber Kusk, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen, Niels Peter Rønnow Sand, Coronary CT angiography-derived fractional flow reserve in-stable angina: association with recurrent chest pain, European Heart Journal - Cardiovascular Imaging, 2021;, jeab198, https://doi.org/10.1093/ehjci/jeab198
