Journal Article

P03 Real-world data from a single centre utilising CT-FFR as the cath lab gatekeeper in patients with stable chest pain

Wells, Tim, Balen Abdulrahman, Khan, Aaron, Veitch, Alice, Sinha, Manas, Alcock, Robin

2023

Overview

IntroductionAnalyse whether Heartflow (HF) has decreased downstream testing in our hospital compared to our previous standard practice based on CADRADS/NICE guidance, along with accuracy of CTFFR compared to invasive pressure wire study( FFR).MethodsRetrospective analysis of 184 patients with new onset stable chest pain undergone CTFFR (CADRADS 3-5) from September 2021- June 2023.CTFFR accuracy results were evaluated by comparing them with invasive FFR (FFR<0.80).ResultsDownstream testsHF positive (n=46): 5 invasive diagnostic angiography (ICA),31 percutaneous coronary intervention( PCI) ,3 awaiting ICA, 2 stress CMRI ,1 stress echo, 2 awaiting stress CMRI and 2/46(4.3%) had no further tests.HF indeterminate(n=30): 4 ICA,9 had PCI, 3 stress echo, 1 exercise tolerance test(ETT), 2 awaiting ICA, 1 awaiting CMRI and 10/30 (33.3%) had no further tests.HF negative(n=108): 7 ICA , 5 had PCI , 3 awaiting ICA, 3 stress CMRI , 1 stress echo, 1 ETT ,1 MPS, 1 awaiting stress CMRI, 3 awaiting echo and 83/108(76%) had no further tests.CTFFR VS FFR: 31/184(16%) patients had subsequent Invasive FFR, 26/31(83%) FFR was equivalent to the CTFFR and 5/31(16%) invasive FFR was different to the CTFFR(3 CTFFR were positive while invasive FFR was negative and 2 CTFFR were negative while invasive FFR was positive).ConclusionHF has significantly reduced our need for downstream testing in the CTCA population. A total of 76% of patients in HF negative group did not have any further tests.In addition, there was high sensitivity of CTFFR when compared to invasive FFR.

• Publisher: BMJ Publishing Group LTD