March 17, 2019 – Patients with negative FFR-CT scans had a low, one-year risk of a heart attack or death.
One-year follow-up results show that a newer, non-invasive technology to evaluate heart pain provided a reliable way to identify which patients had dangerous artery blockages, according to a study co-led by the DCRI.
The findings, reported Sunday at the annual College of Cardiology meeting in New Orleans, suggest that fractional flow reserve CT (FFR-CT) scans are effective in helping doctors determine which patients need more aggressive treatments.
“Our study shows that in clinical practice, when new technology provides a negative result regarding the chance for a physiologically significant stenosis, the patient and physician should be reassured that the chances of major adverse cardiac events are low,” said lead author Manesh Patel, MD, chief of the Division of Cardiology at Duke University School of Medicine.
Patel and colleagues analyzed data from more than 5,000 patients who underwent FFR-CT scans for clinically suspected coronary artery disease. In patients with moderate-to-severe coronary artery disease, a negative FFR-CT was associated with a low, one-year risk of a major cardiac event such as heart attack or death compared to patients with a positive FFR-CT.
Specifically, the researchers found that among those with an FFR-CT reading above 0.80, suggesting blood flow is not dangerously restricted, the cardiovascular death and heart attack risks were significantly lower, and revascularization was significantly lower (5.8 percent vs. 38.4 percent) and was unlikely after 90 days.
“This research, with one-year follow-up, suggests that an FFR-CT test can be trusted when used as it was in this real-world observational registry,” Patel said. “And while we don’t have perfect warranties in medicine, a negative FFR-CT result was seen to have low risk for a major heart event in the following year.”
In addition to Patel, study authors include Bjarne Linde Nørgaard, Timothy A. Fairbairn, Koen Nieman, Takashi Akasaka, Daniel S. Berman, Gilbert L. Raff, Lynne M. Hurwitz Koweek Gianluca Pontone, Tomohiro Kawasaki, Niels Peter Rønnow Sand, Jesper M. Jensen, Tetsuya Amano, Michael Poon, Kristian A. Øvrehus, Jeroen Sonck, Mark G. Rabbat, Sarah Mullen, Bernard De Bruyne, Campbell Rogers, Hitoshi Matsuo, Jeroen J. Bax and Jonathon Leipsic.
The study, called ADVANCE Registry was funded by HeartFlow, Inc., which markets FFR-CT technology. Patel reported receiving research grants from Heartflow.