Prognostic Value of Coronary CT Angiography-Derived Fractional Flow Reserve in Non-obstructive Coronary Artery Disease: A Prospective Multicenter Observational Study

Abstract

Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Myocardial ischemia may occur in patients with normal or non-obstructive CAD on invasive coronary angiography (ICA). The comprehensive evaluation of coronary CT angiography (CCTA) integrated with fractional flow reserve derived from CCTA (CT-FFR) to CAD may be essential to improve the outcomes of patients with non-obstructive CAD. China CT-FFR Study-2 (ChiCTR2000031410) is a large-scale prospective, observational study in 29 medical centers in China. The primary purpose is to uncover the relationship between the CCTA findings (including CT-FFR) and the outcome of patients with non-obstructive CAD. At least 10,000 patients with non-obstructive CAD but without previous revascularization will be enrolled. A 5-year follow-up will be performed. The primary endpoint is the occurrence of major adverse cardiovascular events (MACE), including all-cause mortality, non-fatal myocardial infarct, unplanned revascularization, and hospitalization for unstable angina. Clinical characteristics, laboratory and imaging examination results will be collected to analyze their prognostic value.

Non-contrast CT-based radiomics nomogram of pericoronary adipose tissue for predicting haemodynamically significant coronary stenosis in patients with type 2 diabetes

“…All FFR CT values were calculated with an automated software (“Shukun-FFR” software from Shukun [Beijing] Technology Co., Ltd). As described in the study [ 22 ], the coronary arteries segmentation model and the computational fluid dynamics (CFD) simulation model were used in the "Shukun-FFR" software. The calculation process was as follows: firstly, coronary artery from CCTA image was segmented with a modified V-Net to generate a coronary tree; then, FFR CT values of all points in coronary arteries were calculated automatically by the final reduced-order CFD model computing the flow and pressure of blood.…”

Coronary functional assessment in non-obstructive coronary artery disease: Present situation and future direction

“…However, it is reported that FFR CT value ≤ 0.80 was found in the distal coronary artery segment in asymptomatic male marathon runners with no coronary stenosis ( 98 ), therefore, it is important to interpret the result of FFR CT individually. Most recently, a prospective multicenter observational study, the China CT-FFR Study-2, has conducted to investigate the prognostic value of FFR CT in patient with non-obstructive CAD, which will provide us with a comprehensive risk stratification of FFR CT for non-obstructive CAD ( 99 ).…”