CT Test Simulates Blood Flow to Assess Risk in Patients with Angina

Obtaining Blood Flow Estimate Less Invasively

Of the 900 participants, 523 had normal CT-FFR results (mean age 64, 318 males) and 377 had abnormal CT-FFR results (mean age 65, 264 males). In the normal results group, the rate of three-year adverse outcomes (defined as all-cause deaths and non-fatal myocardial infarction) was 2.1% (11/523). In the abnormal results group, the rate of three-year adverse outcomes was 6.6% (25/377).

Among the participants with normal CT-FFR results and a high coronary artery calcium score, the three-year adverse outcome rate was 2.2% (4/182). Participants with a high coronary artery calcium score and abnormal CT-FFR results had a 9% (19/212) three-year adverse outcome rate.

“Our study provides evidence for the prognostic potential of CT-FFR in patients with high coronary artery calcium scores,” he said. “Regardless of the patient’s baseline risk and extent of coronary artery disease measured by coronary artery calcium, if CT-FFR results are normal, the prognosis is good.”

According to Dr. Madsen, imaging options to assess the impact of coronary artery disease on blood-flow have different strengths and weaknesses. He said CT-FFR exhibits high diagnostic performance, and its results correlate well with invasively measured fractional flow reserve, a procedure that measures blood flow directly within the coronary arteries.

“In my opinion, CT-FFR is the best option because it provides a blood-flow estimate similar to what you would obtain if you performed invasive heart catheterization,” he said. “You get a reliable and quick answer without performing additional tests or putting the patient through an invasive procedure.”

Dr. Madsen said CT-FFR will allow clinicians to divide the coronary artery disease patient population by risk level and focus on improving the prognosis of high-risk patients.

“CT-FFR provides diagnostic and prognostic information beyond what can be obtained from CT angiography alone across a wide range of coronary artery calcium levels,” he said. “It’s a tool that offers a lot of exciting prospects for the future.”

For More Information

Access the Radiology study, “Prognostic Value of Coronary CT Angiography-derived Fractional Flow Reserve on 3-year Outcomes in Patients with Stable Angina,” and the related editorial, “Insights into CT-derived Coronary Fractional Flow Reserve and Coronary Artery Calcification.”

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