Ability of FFR-CT to detect the absence of hemodynamically significant lesions in patients with high-risk NSTE-ACS admitted in the emergency department with chest pain, study design and rationale. (April 2020)

• Record Type: Journal Article
• Authors: Meier, David; Skalidis, Ioannis; De Bruyne, Bernard; Qanadli, Salah Dine; Rotzinger, David; Eeckhout, Eric; Collet, Carlos; Muller, Olivier; Fournier, Stephane
• Is Part Of: IJC heart & vasculature. Volume 27(2020)
• Publication Date: 2020-04
• Subjects: Acute coronary syndrome -- Coronary computed tomography -- Fractional Flow Reserve -- FFR-CT; AE Adverse Event -- ACS Acute coronary syndrome -- CT Computed tomography -- ECG Electrocardiogram -- ED Emergency department -- FFR Fractional Flow Reserve -- FFR-CT FFR derived from coronary CT -- Hs-Tn High-sensitive troponins -- MACE Major adverse cardiac events -- MI Myocardial infraction -- CMRI Cardiac Magnetic resonance imaging -- NSTE-ACS Acute coronary syndromes without ST-segment elevation -- NSTEMI Non-ST-elevation myocardial infarction -- PCI Percutaneous Coronary Intervention -- STEMI ST-elevation myocardial infarction -- URL Upper Range Limit; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2020.100496
• Languages: English
• ISSNs: 2352-9067

Abstract

Abstract: Background: In the era of High-sensitive troponin (hs-Tn), up to 50% of patients with a mild increase of hs-Tn will finally have a normal invasive coronary angiogram. Fractional Flow Reserve (FFR) derived from coronary computed tomographic angiography (FFR-CT) has never been used as a non-invasive tool for the diagnosis of coronary artery disease in patients with high-risk acute coronary syndrome without ST segment elevation (NSTE-ACS). Aims: The study aims to determine the role of coronary CT angiography and FFR-CT in the setting of high-risk NSTE-ACS. Methodology: We will conduct a prospective trial, enrolling 250 patients admitted with high-risk NSTE-ACS who will rapidly undergo a coronary CT angiography and then a coronary angiography with FFR measurements. Results of coronary CT, FFR-CT and coronary angiography (± FFR) will be compared. Potential significance: In conclusion, non-invasive identification of patients with high-risk NSTE-ACS who could avoid coronary angiography would reduce procedure related risks and medical costs.