Objectives: to determine the diagnostic performance of non-invasive FFR derived from standard acquired coronary computed tomography angiography (CTA) datasets (FFRCT) for the diagnosis of myocardial ischemia in patients with suspected stable coronary artery disease (CAD).Methods.Prospective study included 16 patients ((m/f – 13/3 mean age 47.8 ± 2.3 years) with CAD and coronary stenosis 40–75% lumen reduction. Coronary CTA was performed prior to ICA with invasive FFR measurement. FFRCT was calculated and interpreted in a blinded fashion by an independent Core Laboratory (HeartFlow, USA). Results were compared to invasively measured FFR, with ischemia defined as FFRCT or FFR ≤ 0.80.Results. The area under the receiver operating characteristic curve (95% CI) for FFCT was 0.90. Per-vessel sensitivity and specificity to identify myocardial ischemia were 91% and 89% for FFRCT.Conclusion.FFRCT provides high diagnostic accuracy, and discrimination for the diagnosis of hemodynamically significant CAD with invasive FFR as the reference standard.
Patient first versus computed tomography first strategy in testing for stable coronary artery disease: dispelling the prevailing myths and biases
