PhD Scientific Days 2020

Clinical Medicine III. Posters

Diagnostic Performance of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve in Patients with Acute Myocardial Infarction and Moderate Non-Culprit Coronary Stenosis

Előadó neve

Dr. Jablonkai, Balázs

Előadó munkahelye

Bajcsy-Zsilinszky Hospital, Cardiology Department

Előadó telefonszáma

+36307584354

Előadó e-mail címe

jbalazs89@gmail.com

Az előadás címe

Diagnostic Performance of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve in Patients with Acute Myocardial Infarction and Moderate Non-Culprit Coronary Stenosis

Szerző(k) neve és munkahelye

Balázs Jablonkai1, Abdelkrim Ahres1, Gábor Rubóczky1, Béla Nagybaczoni1, Ágnes Őze1, Zsuzsanna Dorka Balogh1, Ágnes Schrancz1, Astrid Apor2, Bálint Szilveszter2, Márton Kolossváry2, Judit Simon2, Béla Merkely2, Pál Maurovich-Horvat2, Péter Andrássy1
(1) Bajcsy-Zsilinszky Hospital, Cardiology, Budapest
(2) Semmelweis University Heart Center, Cardiology, Budapest

Szekció

Clinical Medicine III. Posters

Language of the presentation

Hungarian

Section, first choice

Clinical Medicine

Section, second choice

Theoretical and Translational Medicine

Összefoglaló szövege

Introduction:
Revascularisation of significant non-culprit coronary lesions (NCL) may improve clinical outcome in patients with myocardial infarction and multi vessel disease, however management of moderate NCLs is still controversial. Dobutamine stress echocardiography (DSE) and invasive fractional flow reserve (FFR) are accepted methods to detect myocardial ischemia, nevertheless coronary CT angiography-derived fractional flow reserve (CT-FFR) is a new modality, which has not been widely investigated to date in patients with NCLs.
Aims:
Our aim was to determine the diagnostic performance of CT-FFR compared to DSE and invasive FFR.
Methods:
In this prospective trial, DSE, FFR and CT-FFR were performed in every patient with MI and at least one moderate NCL (30-70% diameter stenosis by visual assessment). New or worsening wall motion abnormality in at least two contiguous myocardial segments on DSE, and FFR value<0.8 in invasive FFR and CT-FFR as well were determined as abnormal. In comparison, DSE and FFR were regarded as reference standard methods.
Results:
Between March of 2017 and December of 2018, 51 patients (58.2±10.4 years, 74.5% male) were enrolled and 71 NCLs (40 LAD, 13 LCx, 18 RCA) were investigated. Dobutamine stress echocardiography, FFR and CT-FFR were positive in 30.9%, 32.3% and 22.5% of all lesions, respectively. FFR values were higher with CT-FFR compared to invasive FFR (0.85±0.11 vs. 0.83±0.08, p<0.05). Compared to DSE, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CT-FFR were 40.9%, 85.7%, 56.2%, 76.3% and 71.8%, respectively. The same values were 39.1%, 85.4%, 56.2%, 74.5% and 70.4% compared to invasive FFR, respectively. Correspondence of CT-FFR with DSE (k=0.29) and with FFR (k=0.27) was weak.
Conclusion:
Our results demonstrated moderate diagnostic accuracy, excellent specificity, poor sensitivity and PPV and acceptable NPV of CT-FFR compared to DSE and FFR. At this stage, CT-FFR is probably not accurate enough to determine revascularisation strategy of moderate NCLs as a single non-invasive method.

Additional Information

Supervisor: Péter Andrássy, andrassy22@yahoo.com

Bemutatás módja

Poszter

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4728

Start

12:34

End

12:37

Authors (legacy)

Balázs Jablonkai1, Abdelkrim Ahres1, Gábor Rubóczky1, Béla Nagybaczoni1, Ágnes Őze1, Zsuzsanna Dorka Balogh1, Ágnes Schrancz1, Astrid Apor2, Bálint Szilveszter2, Márton Kolossváry2, Judit Simon2, Béla Merkely2, Pál Maurovich-Horvat2, Péter Andrássy1
(1) Bajcsy-Zsilinszky Hospital, Cardiology, Budapest
(2) Semmelweis University Heart Center, Cardiology, Budapest