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.
ACS, Acute coronary syndrome
AE, Adverse Event
Acute coronary syndrome
CMRI, Cardiac Magnetic resonance imaging
CT, Computed tomography
Coronary computed tomography
ECG, Electrocardiogram
ED, Emergency department
FFR, Fractional Flow Reserve
FFR-CT
FFR-CT, FFR derived from coronary CT
Fractional Flow Reserve
Hs-Tn, High-sensitive troponins
MACE, Major adverse cardiac events
MI, Myocardial infraction
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
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
15
01
2020
accepted:
27
02
2020
entrez:
18
3
2020
pubmed:
18
3
2020
medline:
18
3
2020
Statut:
epublish
Résumé
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). The study aims to determine the role of coronary CT angiography and FFR-CT in the setting of high-risk NSTE-ACS. 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
The study aims to determine the role of coronary CT angiography and FFR-CT in the setting of high-risk NSTE-ACS.
METHODOLOGY
METHODS
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
UNASSIGNED
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.
Identifiants
pubmed: 32181323
doi: 10.1016/j.ijcha.2020.100496
pii: S2352-9067(20)30043-9
pii: 100496
pmc: PMC7063126
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100496Informations de copyright
© 2020 The Authors. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Dr Fournier reports an institutional consultancy for Bayer and Cathworks. Dr. De Bruyne receives grant support from Abbott, Boston Scientific, Biotronik AG, and St Jude Medical and receives consulting fees on behalf of Dr De Bruyne from St. Jude Medical, Opsens, and Boston Scientific outside of the submitted work Dr. De Bruyne is a shareholder for Siemens, GE, Bayer, Philips, HeartFlow, Edwards Life Sciences, and Ceyliad. Dr. Collet reports receiving research grants from Biosensor, Heart Flow Inc. and Abbott Vascular; and consultancy fees from Heart Flow Inc, Abbott Vascular and Philips Volcano.
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