FINALLY A CTA WITH FFR THAT WE CAN RELY ON.

If you note that many senior cardiologist ( except some old ones ) are missing from town, please know that EuroPCR is o in Paris from 19th-22nd May. So there are quite a few Malaysian Cardiologist wandering around Paris now. I hope that they learn alot and enjoy their brief stay in Paris.
Amongst one of the important papers presented in EuroPCR is the FFRctRIPCORD. This is actually a followup of the earlier RIPCORD study which proved the usefulness in invasive FFR in angiographic assessment of a coronary stenotic lesion. ( Actually a follow-up to FAME ).

In FFRctRIPCORD, ( Led by Dr N Curzen of University Hospital Southampton ), 200 patients with stable cheat pains of uncertain etiology, were subjected to conventional CTA. These CTA were interpreted by 3 independent cardiologist and these patients were advised to undergo management under 4 categories. 1, OMT ( optimal medical therapy ), 2, PCI + OMT, 3. CABG + OMT and 4, MIR ( more information required ). These patients CTA films were then send for assessment using a Heart Flow ( patented ) FFR software, which was approved by FDA in Nov 2014. Reassessment of the same CTA using the Heart Flow FFR software, cause the cardiologist to re-categorise the patients.
The results are shown below.

 Change in Management Recommendations Based on CT Angiography Alone and After Disclosure of FFR-CT Data in 200 Patients

End points	CT angiography alone (% of cohort)	CT angiography plus FFR-CT (% of cohort)*	Change
More data needed	19.0	0
OMT	33.5	56.5	+23
PCI+OMT	43.5	39.0	-5
CABG+OMT	4.0	4.5	+0.5

OMT=optimal medical therapy

FFR-CT=fractional flow reserve at computed tomography

*reallocation P<0 .001="" span="">  

Looks like adding the Heart Flow FFR software improves the clinical accuracy of the CTA and so helps patient management, reducing the need for normal angiograms and increasing the accuracy of the CTA.
This is something that all cardiac scan centers should seriously consider acquiring.