A new study published in Radiology: Cardiothoracic Imaging, a journal of the Radiological Society of North America (RSNA), revealed that a non-invasive imaging test can help identify patients with coronary artery blockage or narrowing who may require a revascularization procedure. Coronary CT angiography (CTA) is commonly used by doctors to diagnose narrowed or blocked arteries in the heart. A CTA exam provides a score ranging from mild to severe, with patients scoring above 3 potentially benefitting from stents or surgeries to restore blood flow to the heart.
Traditional methods rely on invasive procedures such as invasive coronary angiography to image vessels, but more recent alternatives like fractional flow reserve (FFR) have been added to assess significant blockages in the vessels. CT-FFR is a newer non-invasive method that models a patient’s coronary blood flow using CTA images, AI algorithms, and computational fluid dynamics. To evaluate the impact of selective CT-FFR use on clinical outcomes, a retrospective study was conducted on patients who underwent coronary CTA at Massachusetts General Hospital (MGH).
During the study, a total of 2,985 patients were included, with the majority being referred for CT-FFR analysis based on their coronary CTA scores. Patients with moderate narrowing or blockage of the arteries faced ambiguity on who would benefit from invasive testing and revascularization procedures, and CT-FFR was shown to help identify those most likely to benefit. The study indicated that CT-FFR could assist in selecting patients who could benefit from invasive procedures while avoiding unnecessary interventions when not warranted.
Results from the study showed that patients with significant narrowing or blockages who underwent CT-FFR had lower rates of invasive coronary angiography and subsequent percutaneous coronary intervention compared to those who did not undergo CT-FFR. The benefits of CT-FFR were most pronounced when used selectively, helping to guide treatment decisions in patients with significant coronary artery issues. Researchers noted that CT-FFR analysis was successful in the majority of patients, even in those with challenging factors such as elevated heart rates or obesity.
The findings of the study underscore the potential utility of CT-FFR in clinical practice when used selectively, as it has the ability to reduce the frequency of invasive procedures in patients with significant coronary artery issues without compromising safety. CT-FFR provides an objective measurement of coronary artery flow, allowing for more accurate treatment decisions based on physiological data rather than visual observations alone. The researchers emphasized that CT-FFR can improve patient outcomes by helping to identify those who will benefit most from invasive procedures while avoiding unnecessary interventions in others.
