PhD Scientific Days 2021

CL_II_P: Clinical Medicine II. Posters

On-site coronary CT - derived FFR for the assessment of non-culprit lesions in patients who suffered myocardial infarction

Judit Simon MD1, Bálint Szilveszter MD PhD1, Ahres Abdelkrim MD2, Balázs Jablonkai2, Márton Kolossváry MD PhD1, Béla Merkely MD PhD MSc1, Péter Andrássy MD PhD DSc1, Pál Maurovich-Horvat MD PhD MPH DSC3
1 Heart and Vascular Center, Semmelweis University, Budapest
2 Bajcsy Zsilinszky Hospital, Budapest
3 Medical Imaging Centre, Semmelweis Univesrity, Budapest

Text of the abstract

Objective
Prior studies demonstrated that CT-derived fractional flow reserve (CT-FFR) has excellent diagnostic accuracy for the identification of ischemia-causing lesions in patients with stable chest pain. Non-invasive assessment of non-culprit lesions in patients who suffered myocardial infarction (MI) could improve risk stratification and guide therapy.
Methods
We enrolled 40 patients (55.93±8.5 years, 22.0% female) who suffered MI with 59 non-culprit coronary lesions. CT-FFR was calculated with an on-site algorithm and values were compared to invasive FFR measured at the index event. FFR value <0.80 was considered hemodynamically significant in both cases.
Results
The mean FFR-CT value was 0.85±0.09 while the mean invasive FFR value was 0.84±0.06. The sensitivity, specificity, positive predictive value and negative predictive value of FFR-CT versus invasive FFR was 56.25%, 92.86%, 75.0% and 84.78%, respectively (AUC=0.83). Correlation coefficient between CT-FFR and invasive FFR was 0.56 (p<0.001).
Conclusion
The majority of non-culprit lesions of MI patients are in the grey-zone for FFR-CT and therefore the diagnostic performance of FFR-CT for the detection of lesion-specific ischemia in post-MI patients is moderate. However, the high specificity of FFR-CT in this patient population might be useful test characteristics to identify patients who need revascularization.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine