Titre
Impact of FFR-CT before coronary angiography on the management of non-culprit lesions among high-risk NSTE-ACS patients.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Zimmerli, A.
Auteure/Auteur
Meier, D.
Auteure/Auteur
Salihu, A.
Auteure/Auteur
Liabot, Q.
Auteure/Auteur
Weerts, V.
Auteure/Auteur
Skalidis, I.
Auteure/Auteur
Andreini, D.
Auteure/Auteur
Cosyns, B.
Auteure/Auteur
Storozhenko, T.
Auteure/Auteur
Mahendiran, T.
Auteure/Auteur
Assanelli, E.
Auteure/Auteur
Sonck, J.
Auteure/Auteur
Roosens, B.
Auteure/Auteur
Rotzinger, D.C.
Auteure/Auteur
Qanadli, S.D.
Auteure/Auteur
Tzimas, G.
Auteure/Auteur
De Bruyne, B.
Auteure/Auteur
Collet, C.
Auteure/Auteur
Muller, O.
Auteure/Auteur
Fournier, S.
Auteure/Auteur
Liens vers les unités
ISSN
1876-4738
Statut éditorial
Accepté (sous presse)
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Letter
Publication Status: aheadofprint
Publication Status: aheadofprint
Résumé
Recent data suggest that fractional flow reserve derived from coronary computed tomography (FFR-CT) can help select patients with high-risk non-ST-elevation acute coronary syndrome (NSTE-ACS) requiring invasive coronary angiography (ICA). Multiple stenoses are often observed in this population, and while a clear culprit is frequently identified, the management of intermediate lesions remains challenging. The information provided by FFR-CT prior to the ICA could theoretically assist in the management of these lesions. A prespecified post-hoc analysis of a multicenter, single-arm, double-blinded, core-laboratory adjudicated study was conducted to evaluate the potential of FFR-CT to assess the non-culprit lesions among patients with an identified culprit lesion on ICA and one additional vessel with a stenosis ≥30 %. The primary endpoint was the performance of FFR-CT in ruling out hemodynamically significant lesions in non-culprit vessels, with invasive FFR as gold standard. A total of 49 patients with 67 non-culprit lesions were included. FFR-CT classified 33 lesions (49 %) as non-significant and 34 (51 %) as significant. Among the 33 lesions deemed negative by FFR-CT, 31 were confirmed negative by invasive FFR, resulting in a negative predictive value of 94 %. Similarly, among the 34 lesions classified as significant by FFR-CT, 26 were confirmed as positive by invasive FFR, resulting in a positive predictive value of 93 %. In patients with high-risk NSTE-ACS, FFR-CT has the potential to not only reduce the number of unnecessary ICAs, but also to support early decision-making regarding the management of non-culprit lesions.
PID Serval
serval:BIB_B192AD76AE9F
PMID
Date de création
2025-05-09T13:51:14.080Z
Date de création dans IRIS
2025-05-21T04:53:54Z