{Reference Type}: Journal Article
{Title}: Completeness of revascularization by FFRCT in stable angina: Association to adverse cardiovascular outcomes.
{Author}: Madsen KT;Nørgaard BL;Øvrehus KA;Jensen JM;Parner E;Grove EL;Mortensen MB;Iraqi N;Fairbairn TA;Nieman K;Patel MR;Rogers C;Mullen S;Mickley H;Thomsen KK;Bøtker HE;Leipsic J;Rønnow Sand NP;
{Journal}: J Cardiovasc Comput Tomogr
{Volume}: 18
{Issue}: 5
{Year}: 2024 Sep-Oct 17
暂无{DOI}: 10.1016/j.jcct.2024.07.007
{Abstract}: <B>BACKGROUND: </B>The prognostic impact of complete coronary revascularization relative to non-invasive testing methods is unknown.<BR><B>OBJECTIVE: </B>To assess the association between completeness of revascularization defined by CTA-derived fractional flow reserve (FFRCT) and cardiovascular outcomes in patients with stable angina.<BR><B>METHODS: </B>Multicenter 3-year follow-up study of patients with new onset stable angina and ≥ 30% stenosis by CTA. The lesion-specific FFRCT value (two cm-distal-to-stenosis) was registered in all vessels with stenosis and considered abnormal when ≤ 0.80. Patients with FFRCT ≤ 0.80 were categorized as: Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤ 0.80 revascularized; incompletely revascularized (IR-FFRCT), ≥ 1 vessels with FFRCT ≤ 0.80 non-revascularized. Early revascularization (< 90 days from index CTA) categorized vessels as revascularized. The primary endpoint comprised cardiovascular death and non-fatal myocardial infarction; the secondary endpoint vessel-specific late revascularization and non-fatal myocardial infarction.<BR><B>RESULTS: </B>Amongst 900 patients and 1759 vessels, FFRCT was ≤ 0.80 in 377 (42%) patients, 536 (30%) vessels; revascularization was performed in 244 (27%) patients, 340 (19%) vessels. Risk of the primary endpoint was higher for IR-FFRCT (15/210 [7.1%]) compared to CR-FFRCT (4/167 [2.4%]), RR: 2.98; 95% CI: 1.01-8.8, p ​= ​0.036, and to normal FFRCT (3/523 [0.6%]), RR: 12.45; 95% CI: 3.6-42.6, p ​< ​0.001. Incidence of the secondary endpoint was higher in non-revascularized vessels with FFRCT ≤ 0.80 (29/250 [12%]) compared to revascularized vessels with FFRCT ≤ 0.80 (5/286 [1.7%]), p ​= ​0.001, and to vessels with FFRCT > 0.80 (10/1223 [0.8%]), p ​< ​0.001.<BR><B>CONCLUSIONS: </B>Incomplete revascularization of patients with lesion-specific FFRCT ≤ 0.80 is associated to unfavorable cardiovascular outcomes compared to those with complete revascularization or FFRCT > 0.80.