Skip to main content
Journal cover image

Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry.

Publication ,  Journal Article
Nous, F; Budde, RPJ; Fairbairn, TA; Akasaka, T; Nørgaard, BL; Berman, DS; Raff, G; Hurwitz-Koweek, LM; Pontone, G; Kawasaki, T; Sand, NPR ...
Published in: J Cardiovasc Comput Tomogr
2021

BACKGROUND: The ADVANCE registry is a large prospective study of outcomes and resource utilization in patients undergoing coronary computed tomography angiography (CCTA) and CT-based fractional flow reserve (FFRCT). As experience with new technologies and practices develops over time, we investigated temporal changes in the use of FFRCT within the ADVANCE registry. METHODS: 5083 patients with coronary artery disease (CAD) on CCTA were prospectively enrolled in the ADVANCE registry and were divided into 3 equally sized cohorts based on the temporal order of enrollment per site. Demographics, CCTA and FFRCT findings, and clinical outcomes through 1-year follow-up, were recorded and compared between tertiles. RESULTS: The number of patients with a ≥70% stenosis on CCTA was similar over time (33.6%, 30.9%, and 33.8% for cohort 1-3). The rate of positive FFRCT ≤0.80 was higher for cohorts 2 (67.3%) and 3 (74.6%) than for cohort 1 (57.1%, p < 0.001). Invasive FFR rates decreased from 25.8% to 22.4% between cohort 1 and 3 (p = 0.023). Moreover, patients with a FFRCT ≤0.80 were less frequently referred for invasive coronary angiography (ICA) (from 62.9% to 52.9%, p < 0.001), and underwent fewer revascularizations between cohort 1 and 3 (from 41.9% to 32.0%, p < 0.001). The prevalence of major events was low (1.2%) and similar between cohorts. CONCLUSIONS: Growing experience with FFRCT improved the likelihood of identifying hemodynamically significant CAD and safely reduced the need for ICA and revascularization in patients with anatomically significant disease even in the instance of an abnormal FFRCT.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Cardiovasc Comput Tomogr

DOI

EISSN

1876-861X

Publication Date

2021

Volume

15

Issue

1

Start / End Page

48 / 55

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Registries
  • Referral and Consultation
  • Prospective Studies
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • North America
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nous, F., Budde, R. P. J., Fairbairn, T. A., Akasaka, T., Nørgaard, B. L., Berman, D. S., … Nieman, K. (2021). Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry. J Cardiovasc Comput Tomogr, 15(1), 48–55. https://doi.org/10.1016/j.jcct.2020.04.011
Nous, Fay, Ricardo P. J. Budde, Timothy A. Fairbairn, Takashi Akasaka, Bjarne L. Nørgaard, Daniel S. Berman, Gilbert Raff, et al. “Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry.J Cardiovasc Comput Tomogr 15, no. 1 (2021): 48–55. https://doi.org/10.1016/j.jcct.2020.04.011.
Nous F, Budde RPJ, Fairbairn TA, Akasaka T, Nørgaard BL, Berman DS, et al. Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry. J Cardiovasc Comput Tomogr. 2021;15(1):48–55.
Nous, Fay, et al. “Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry.J Cardiovasc Comput Tomogr, vol. 15, no. 1, 2021, pp. 48–55. Pubmed, doi:10.1016/j.jcct.2020.04.011.
Nous F, Budde RPJ, Fairbairn TA, Akasaka T, Nørgaard BL, Berman DS, Raff G, Hurwitz-Koweek LM, Pontone G, Kawasaki T, Sand NPR, Jensen JM, Amano T, Poon M, Øvrehus KA, Sonck J, Rabbat MG, Mullen S, De Bruyne B, Rogers C, Matsuo H, Bax JJ, Leipsic J, Patel MR, Nieman K. Temporal changes in FFRCT-Guided Management of Coronary Artery Disease - Lessons from the ADVANCE Registry. J Cardiovasc Comput Tomogr. 2021;15(1):48–55.
Journal cover image

Published In

J Cardiovasc Comput Tomogr

DOI

EISSN

1876-861X

Publication Date

2021

Volume

15

Issue

1

Start / End Page

48 / 55

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Registries
  • Referral and Consultation
  • Prospective Studies
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • North America
  • Middle Aged
  • Male