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

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