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

• Published in: International journal of cardiology. Heart & vasculature 2020-04, Vol.27, p.100496, Article 100496
• Main Authors: Meier, David, Skalidis, Ioannis, De Bruyne, Bernard, Qanadli, Salah Dine, Rotzinger, David, Eeckhout, Eric, Collet, Carlos, Muller, Olivier, Fournier, Stephane
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Coronary computed tomography; FFR-CT; Fractional Flow Reserve; Original Paper
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2020.100496

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.