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Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry.

Publication ,  Journal Article
Kitabata, H; Leipsic, J; Patel, MR; Nieman, K; De Bruyne, B; Rogers, C; Pontone, G; Nørgaard, BL; Bax, JJ; Raff, G; Chinnaiyan, KM; Rabbat, M ...
Published in: J Cardiovasc Comput Tomogr
2018

BACKGROUND: To date, the clinical utility of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT) has been limited to trials and single center experiences. We herein report the incidence of abnormal FFRCT (≤0.80) and the relationship of lesion-specific ischemia to subject demographics, symptoms, and degree of stenosis in the multicenter, prospective ADVANCE registry. METHODS: One thousand patients with suspected angina having documented coronary artery disease on coronary CTA and clinically referred for FFRCT were prospectively enrolled in the registry. Patient demographics, symptom status, coronary CTA and FFRCT findings were recorded. Univariate and multivariate analyses were performed to investigate the predictors related to abnormal FFRCT. RESULTS: FFRCT data were analyzed in 952 patients (95.2%). Overall, 51.1% patients had a positive FFRCT value (≤0.80). Patients with ≥3 risk factors had a significantly higher rate of abnormal FFRCT than those with <3 risk factors (60.2% vs. 43.9%, p = 0.0001). On multivariate analysis, baseline diabetes (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.04-2.21, p = 0.030) and hypertension (OR 1.56, 95%CI 1.14-2.14, p = 0.005) were both predictive of abnormal FFRCT. In addition, >70% stenosis was significantly associated with low FFRCT (OR 31.16, 95%CI 12.25-79.22, p < 0.0001) vs. <30% stenosis. Notably, stenosis 30-49% vs. <30% had an increased likelihood of ischemia (OR 3.74, 95%CI 1.52-9.17, p < 0.0001). CONCLUSIONS: In this real-world registry, CT angiographic stenosis severity in addition to baseline cardiovascular risk factors conferred an increased likelihood of an abnormal FFRCT. Importantly, however, mild CT angiographic stenoses were noted to have an increased hazard for ischemia and the converse holding true for more severe stenoses as well.

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Published In

J Cardiovasc Comput Tomogr

DOI

EISSN

1876-861X

Publication Date

2018

Volume

12

Issue

2

Start / End Page

95 / 100

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Risk Factors
  • Reproducibility of Results
  • Registries
  • Prospective Studies
  • Predictive Value of Tests
  • Odds Ratio
  • North America
  • Multivariate Analysis
  • Multidetector Computed Tomography
 

Citation

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MLA
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Kitabata, H., Leipsic, J., Patel, M. R., Nieman, K., De Bruyne, B., Rogers, C., … Akasaka, T. (2018). Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry. J Cardiovasc Comput Tomogr, 12(2), 95–100. https://doi.org/10.1016/j.jcct.2018.01.008
Kitabata, Hironori, Jonathon Leipsic, Manesh R. Patel, Koen Nieman, Bernard De Bruyne, Campbell Rogers, Gianluca Pontone, et al. “Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry.J Cardiovasc Comput Tomogr 12, no. 2 (2018): 95–100. https://doi.org/10.1016/j.jcct.2018.01.008.
Kitabata H, Leipsic J, Patel MR, Nieman K, De Bruyne B, Rogers C, et al. Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry. J Cardiovasc Comput Tomogr. 2018;12(2):95–100.
Kitabata, Hironori, et al. “Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry.J Cardiovasc Comput Tomogr, vol. 12, no. 2, 2018, pp. 95–100. Pubmed, doi:10.1016/j.jcct.2018.01.008.
Kitabata H, Leipsic J, Patel MR, Nieman K, De Bruyne B, Rogers C, Pontone G, Nørgaard BL, Bax JJ, Raff G, Chinnaiyan KM, Rabbat M, Rønnow Sand NP, Blanke P, Fairbairn TA, Matsuo H, Amano T, Kawasaki T, Morino Y, Akasaka T. Incidence and predictors of lesion-specific ischemia by FFRCT: Learnings from the international ADVANCE registry. J Cardiovasc Comput Tomogr. 2018;12(2):95–100.
Journal cover image

Published In

J Cardiovasc Comput Tomogr

DOI

EISSN

1876-861X

Publication Date

2018

Volume

12

Issue

2

Start / End Page

95 / 100

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Risk Factors
  • Reproducibility of Results
  • Registries
  • Prospective Studies
  • Predictive Value of Tests
  • Odds Ratio
  • North America
  • Multivariate Analysis
  • Multidetector Computed Tomography