The clinical utility of FFRCT stratified by age
| Autor: | Hitoshi Matsuo, Jesper M. Jensen, Phillip Blanke, Koen Nieman, Jeroen Sonck, Malcom Anastasius, Jeroen J. Bax, Gianluca Pontone, Jonathon Leipsic, Tomohiro Kawasaki, Niels Peter Rønnow Sand, Bjarne L. Nørgaard, Mark G. Rabbat, Paul Maggiore, Tetsuya Amano, Gilbert L. Raff, Alex L. Huang, Campbell Rogers, Daniel S. Berman, Lynne M. Hurwitz Koweek, Bernard De Bruyne, Takashi Akasaka, Sarah Mullen, Michael Poon, Timothy A. Fairbairn, Kristian A. Øvrehus, Manesh R. Patel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Fractional flow reserve 030204 cardiovascular system & hematology Clinical practice Logistic regression Coronary artery disease 030218 nuclear medicine & medical imaging Odds 03 medical and health sciences 0302 clinical medicine Age Internal medicine Clinical outcomes medicine Radiology Nuclear Medicine and imaging cardiovascular diseases business.industry Incidence (epidemiology) CT fractional Flow reserve medicine.disease CT coronary Angiogram Invasive coronary angiography Conventional PCI Cardiology Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | Anastasius, M, Maggiore, P, Huang, A, Blanke, P, Patel, M R, Nørgaard, B L, Fairbairn, T A, Nieman, K, Akasaka, T, Berman, D S, Raff, G L, Hurwitz Koweek, L M, Pontone, G, Kawasaki, T, Rønnow Sand, N P, Jensen, J M, Amano, T, Poon, M, Øvrehus, K A, Sonck, J, Rabbat, M G, Mullen, S, De Bruyne, B, Rogers, C, Matsuo, H, Bax, J J & Leipsic, J 2021, ' The clinical utility of FFR CT stratified by age ', Journal of Cardiovascular Computed Tomography, vol. 15, no. 2, pp. 121-128 . https://doi.org/10.1016/j.jcct.2020.08.006 Journal of Cardiovascular Computed Tomography, 15(2), 121-128. ELSEVIER SCIENCE INC |
| DOI: | 10.1016/j.jcct.2020.08.006 |
| Popis: | Background: CT coronary angiography (CTA) with Fractional Flow Reserve as determined by CT (FFR CT) is a safe alternative to invasive coronary angiography. A negative FFR CT has been shown to have low cardiac event rates compared to those with a positive FFR CT. However, the clinical utility of FFR CT according to age is not known. Methods: Patients’ in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) registry, were stratified into those ≥65 or CT on clinical decision-making, as assessed by patient age, was determined by evaluating patient management using CTA results alone, followed by site investigators submitting a report on the treatment plan based upon the newly provided FFR CT data. Outcomes at 1-year post CTA were assessed, including major adverse cardiovascular events (myocardial infarction, all-cause mortality or unplanned hospitalization for ACS leading to revascularisation) and total revascularisation. Positive FFR CT was deemed to be ≤ 0.8. Results: FFR CT was calculated in 1849 (40.6%) subjects aged CT strata for subjects above and below the age of 65. MACE and revascularisation rates were not significantly different for those ≥ or CT positivity or stenosis severity CT result, and anatomical stenosis ≥50%, those ≥ and CT and treatment (CABG, PCI, medical therapy), indicated a statistically significant, but small increase in the odds of a MACE event with increasing age (OR 1.04, 95% CI 1.006–1.08, p = 0.02). Amongst patients with a FFR CT > 0.80, there was no effect of age on the odds of revascularisation. Conclusion: The findings of this study point to a low risk of MACE events or need for revascularisation in those aged ≥ or CT>0.80, despite the higher incidence of anatomic obstructive CAD in those ≥65 years. The findings show the clinical usefulness and outcomes of FFR CT are largely constant regardless of age. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|