Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions
Key result
Adding low-density non-calcified plaque volume and FFRCT to standard stenosis assessment improved the discrimination of lesion-specific ischaemia (AUC increased from 0.71 to 0.90).
Why the study?
Does coronary CTA-derived plaque quantification and FFRCT improve the identification of ischemia-causing lesions compared to stenosis severity alone in patients undergoing coronary CTA?
Population
254 patients (484 vessels) from the NXT trial substudy
Comparison
Coronary CTA-derived plaque quantification and… vs Coronary CTA stenosis severity assessment alone
Design
Cross-sectional
Authors
Discussion
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Implication
May improve selection for invasive angiography post-CTA; leaves open effects on clinical outcomes pending prospective trials.
Study Design
Type
Observational (n=254)
Structured PICO
Does coronary CTA-derived plaque quantification and FFRCT improve the identification of ischemia-causing lesions compared to stenosis severity alone in patients undergoing coronary CTA?
P
Population
254 patients (484 vessels) from the NXT trial substudy
I
Intervention
Coronary CTA-derived plaque quantification (non-calcified plaque, low-density non-calcified plaque, calcified plaque) and FFRCT
C
Comparator
Coronary CTA stenosis severity assessment alone (>50% stenosis)
O
Outcome
Lesion-specific ischaemia defined by FFR or FFRCT ≤0.80surrogate
Main Result
Effect estimate: RR 13.6 (95% CI 8.4-21.9)
Coronary CTA-derived plaque assessment and FFRCT provide improved discrimination of lesion-specific ischemia compared with stenosis assessment alone.
Cite This Study
Gaur et al. (2016) conducted an observational in Coronary stenosis and ischaemia (n=254). Coronary CTA plaque quantification and FFRCT vs. Coronary stenosis assessment alone was evaluated on Lesion-specific ischaemia defined by FFR ≤0.80 (RR 13.6, 95% CI 8.4-21.9). Adding low-density non-calcified plaque volume and FFRCT to standard stenosis assessment improved the discrimination of lesion-specific ischaemia (AUC increased from 0.71 to 0.90).