Cardiology · 3 h ago
Nationwide Cohort Links Lower FFR-CT Values to Higher Cardiovascular Risk
In a nationwide observational cohort of 7,836 patients with stable coronary artery disease, lower coronary CT-derived fractional flow reserve (FFR-CT) values were associated with higher rates of myocardial infarction and death over three years. Adding FFR-CT modestly improved risk discrimination beyond clinical risk factors and coronary stenosis severity.
- Cohort included 7,836 patients across 27 English sites.
- Lower FFR-CT values were associated with higher event risk.
- Adding FFR-CT modestly improved risk discrimination.
- Normal stenosis-specific FFR-CT was associated with low event rates.
Researchers studied 7,836 patients who underwent coronary CT angiography and clinically indicated FFR-CT analysis at 27 sites across England between 2017 and 2020. The cohort’s median age was 63 years, and 37.4% were women. Investigators assessed stenosis-specific and distal-vessel FFR-CT in relation to myocardial infarction (MI), cardiovascular and all-cause mortality, and revascularization during three years of follow-up.
Lower stenosis-specific FFR-CT values were associated with progressively greater risk. After adjustment for cardiovascular risk factors and stenosis severity, values of 0.7 or below were associated with MI (adjusted hazard ratios, 2.94–3.39); values of 0.5 or below were associated with cardiovascular death (2.92) and all-cause death (1.49). FFR-CT also improved discrimination for MI or cardiovascular death compared with a model based on risk factors and stenosis severity, although the increase in C index was modest (0.012). The study identified 0.67 as the optimal risk cutoff.
This observational analysis supports the prognostic value of FFR-CT in this population, but does not establish that using the measure to guide treatment improves outcomes. Stenosis-specific and distal-vessel measurements were discordant in 36.4% of patients; when stenosis-specific FFR-CT was normal, the three-year rate of MI or cardiovascular death was 1.5%.
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Circulation: Prognostic Value of Coronary Computed Tomography Angiography–Derived Fractional Flow Reserve From a Large Nationwide Cohort ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.