Predictive value of coronary artery computed tomography-derived fractional flow reserve for cardiovascular events in patients with coronary artery disease

Abstract

Background: Coronary computed tomography-derived fractional flow reserve (FFR-CT) assesses whether coronary artery lesions will result in myocardial ischemia. Aim: This study aimed to evaluate the predictive value of FFR-CT for cardiovascular events in patients with coronary artery disease (CAD). Methods: Data were collected retrospectively from patients with CAD who underwent FFR-CT at our hospital from January 2020 to February 2022 (1-year average follow-up). Patients were divided into ischemic (FFR-CT ≤ 0.80) and non-ischemic (FFR-CT > 0.80) groups. The incidence of endpoint events (cardiac death, acute myocardial infarction, unplanned revascularization, unstable angina, and stable angina) was calculated. The FFR-CT value was correlated with endpoint events using Cox regression models and Kaplan-Meier survival curves. Results: We recruited 134 patients (93 [69.4%] and 41 [30.6%] patients in the ischemic and non-ischemic groups, respectively). Compared to the non-ischemic group, the ischemic group had a higher proportion of men, patients with type 2 diabetes and hypertension, and patients taking antiplatelet drugs and β-blockers (all P < 0.05). Other parameters were comparable. Multivariate Cox regression analysis revealed no significant differences between the groups for cardiac death, acute myocardial infarction, unplanned revascularization, and unstable angina; the incidence of stable angina events (HR=3.092, 95% CI: 1.362–7.022, P = 0.007) was significantly higher in the ischemic group. Kaplan-Meier survival analysis identified a significant difference in event-free survival for stable angina between the groups (P = 0.002). Conclusion: FFR-CT showed an independent predictive value for stable angina within 1 year of examination in patients with CAD.