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首页> 外文期刊>Journal of Clinical Medicine >Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Safely Defers Invasive Coronary Angiography in Patients with Stable Coronary Artery Disease
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Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography Safely Defers Invasive Coronary Angiography in Patients with Stable Coronary Artery Disease

机译：冠状动脉计算机断层造影血管造影的分数流量储备安全缺血冠状动脉疾病患者侵袭性冠状动脉造影

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Objectives: In the United States, the real-world feasibility and outcome of using fractional flow reserve from coronary computed tomography angiography (FFR CT ) is unknown. We sought to determine whether a strategy that combined coronary computed tomography angiography (CTA) and FFR CT could safely reduce the need for invasive coronary angiography (ICA), as compared to coronary CTA alone. Methods: The study included 387 consecutive patients with suspected CAD referred for coronary CTA with selective FFR CT and 44 control patients who underwent CTA alone. Lesions with 30–90% diameter stenoses were considered of indeterminate hemodynamic significance and underwent FFR CT . Nadir FFR CT ≤ 0.80 was positive. The rate of patients having ICA, revascularization and major adverse cardiac events were recorded. Results: Using coronary CTA and selective FFR CT , 121 patients (32%) had at least one vessel with ≥50% diameter stenosis; 67/121 (55%) patients had at least one vessel with FFR CT ≤ 0.80; 55/121 (45%) underwent ICA; and 34 were revascularized. The proportion of ICA patients undergoing revascularization was 62% (34 of 55). The number of patients with vessels with 30–50% diameter of stenosis was 90 (23%); 28/90 (31%) patients had at least one vessel with FFR CT ≤ 0.80; 8/90 (9%) underwent ICA; and five were revascularized. In our institutional practice, compared to coronary CTA alone, coronary CTA with selective FFR CT reduced the rates of ICA (45% vs. 80%) for those with obstructive CAD. Using coronary CTA with selective FFR CT , no major adverse cardiac events occurred over a mean follow-up of 440 days. Conclusion: FFR CT safely deferred ICA in patients with CAD of indeterminate hemodynamic significance. A high proportion of those who underwent ICA were revascularized.
机译：目标：在美国，使用冠状动脉计算机断层造影血管造影（FFR CT）使用分数流量储备的现实世界可行性和结果是未知的。我们试图确定组合冠状动脉计算机断层造影血管造影（CTA）和FFR CT的策略是否可以安全地减少对侵入性冠状动脉造影（ICA）的需求，与单独的冠状动脉CTA相比。方法：该研究包括387名患有疑似CAD的患者，冠心CTA具有选择性FFR CT和44患者单独接受CTA的患者。具有30-90％直径狭窄的病变被认为是不确定的血流动力学意义和涉及FFR CT。 Nadir FFRCT≤0.80是阳性的。记录了ICA，血运重建和主要不良心脏事件的患者的速率。结果：使用冠状动脉CTA和选择性FFR CT，121名患者（32％）具有至少一个血管直径≥50％的血管; 67/121（55％）患者至少有一个血管，FFRCT≤0.80; 55/121（45％）接受了ICA; 34是血运重建的。接受血运重建的ICA患者的比例为62％（34％，共55％）。血管直径30-50％直径的血管数量为90（23％）; 28/90（31％）患者至少有一个FFRCT≤0.80的血管; 8/90（9％）接受了ICA;五，五是血运重建的。在我们的制度实践中，与单独的冠状动脉CTA相比，具有选择性FFR的冠状动脉CTA CT降低了ICA（45％vs.80％）的抑制性CAD的速率。使用具有选择性FFR CT的冠状动脉CTA，在440天的平均随访中没有发生重大不良心脏事件。结论：FFR CT安全延迟ICA，CAD不确定血流动力学意义。那些接受了ICA的高比例是血运动症。

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