Non-invasive fractional flow reserve (FFRCT) in the evaluation of acute chest pain – Concepts and first experiences

Eur J Radiol. 2021 Mar 8;138:109633. doi: 10.1016/j.ejrad.2021.109633. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate 30 day rate of major adverse cardiac events (MACE) utilizing cCTA and FFR_CT for evaluation of patients presenting to the Emergency Department (ED) with acute chest pain.

MATERIALS AND METHODS: Patients between the ages of 18-95 years who underwent clinically indicated cCTA and FFR_CT in the evaluation of acute chest pain in the emergency department were retrospectively evaluated for 30 day MACE, repeat presentation/admission for chest pain, revascularization, and additional testing.

RESULTS: A total of 59 patients underwent CCTA and subsequent FFR_CT for the evaluation of acute chest pain in the ED over the enrollment period. 32 out of 59 patients (54 %) had negative FFR_CT (>0.80) out of whom 18 patients (55 %) were discharged from the ED. Out of the 32 patients without functionally significant CAD by FFR_CT, 32 patients (100 %) underwent no revascularization and 32 patients (100 %) had no MACE at the 30-day follow-up period.

CONCLUSION: In this limited retrospective study, patients presenting to the ED with acute chest pain and with CCTA with subsequent FFR_CT of >0.8 had no MACE at 30 days; however, for many of these patients results were not available at time of clinical decision making by the ED physician.

PMID:33735700 | DOI:10.1016/j.ejrad.2021.109633