News | Computed Tomography (CT) | September 03, 2015

Non-Invasive FFR-CT Reduces Invasive Tests in Chest Pain Patients

Sixty-one percent of patients in PLATFORM trial had invasive tests canceled following FFR-CT analysis

FFR-CT, HeartFlow, PLATFORM trial, ESC 2015, ICA, fractional flow reserve, computed tomography

Image courtesy of HeartFlow

September 3, 2015 — Results of the PLATFORM trial indicate fractional flow reserve computed tomography (FFR-CT) can obviate the need for invasive tests in up to 61 percent of patients with chest pain and suspected coronary artery disease. The results were presented at the European Society of Cardiology (ESC) Congress 2015.

FFR-CT estimates blood flow and pressure in the coronary artery using images from computed tomography angiography (CTA).

“This approach significantly reduced the need for unnecessary invasive coronary angiography (ICA) which, although it is the gold standard for investigating chest pain, comes with the risk and costs of an invasive procedure,” said lead investigator Pamela Douglas, M.D., the Ursula Geller Professor at the Duke Clinical Research Institute, Duke University School of Medicine.

“The message is that for stable chest pain patients in whom elective ICA is recommended, consideration should be given to performing this new test first.”

When used alone, CTA can identify an abnormal narrowing (stenosis) in the coronary arteries but it cannot quantify how much this actually obstructs blood flow. Therefore “many patients who have blockages that are not interfering with blood flow may end up undergoing ICAs that show no evidence of obstructive coronary artery disease (CAD) and could possibly have been avoided, “ explained Douglas.

Other commonly used non-invasive tests for CAD, such as myocardial perfusion stress imaging or stress echocardiography, may tell whether blood supply to the heart tissue is adequate but cannot determine whether a specific blockage is obstructing blood flow, she said.

The current standard for assessing the significance of coronary artery narrowing is conventional FFR, which is invasive, involving insertion of a wire into the coronary artery.

But by using computer simulations to calculate blood flow, non-invasive FFR-CT can give a comprehensive evaluation of a patient’s chest pain without the need for an invasive procedure.

The PLATFORM study included 584 chest pain patients (average age 60.9 years) from 11 test centers in Europe.

Patients were evaluated using either FFR-CT, via the HeartFlow FFR-CT Analysis software from HeartFlow (n=297), or conventional testing (n=287) to see if FFR-CT  could reduce the rate of ICAs that show no obstructive CAD.

Patients were divided into those in whom “usual care” would dictate a non-invasive investigation such as stress testing or conventional CTA (n=204) and those who would have proceeded straight to an invasive ICA (n=380).

In both groups patients were then allocated to receive either usual care (invasive or non-invasive) or FFR-CT — defined as CTA with the addition of FFR when appropriate.

Among patients already scheduled for an ICA, 73 percent in the usual care group underwent ICA only to find no significant blockages, compared to 12 percent in the FFR-CT group. Furthermore, 61 percent of patients in the FFR-CT group had the ICA cancelled based on the FFR-CT results.

While FFR-CT reduced the number of patients who underwent an ICA that found no significant disease, there was no difference between the two groups in the rate of revascularization procedures, such as stenting and coronary artery bypass surgery.

No clinical adverse events were reported at the 90-day follow-up in patients whose physicians chose to cancel ICAs based on FFR-CT guided strategy

“The study shows that CTA plus FFR-CT more effectively triages patients for invasive procedures than usual care strategies,” said Douglas.

“Although FFR-CT is a relatively new technique, PLATFORM demonstrates that it is feasible and safe with high utility in busy clinical settings.” 

FFR-CT from HeartFlow received CE Mark in 2010 and received U.S. Food and Drug Administration clearance in November 2014. The technology has been evaluated in four large, clinical trials enrolling a total of more than 1,100 patients

For more information: www.escardio.org

Related Content

FDA Clears Siemens Healthineers' GOKnee3D MRI Application
Technology | Magnetic Resonance Imaging (MRI) | February 19, 2018
February 19, 2018 — The U.S.
Arterys Receives First FDA Clearance for Oncology Imaging Suite With Deep Learning
Technology | Artificial Intelligence | February 15, 2018
February 15, 2018 — Arterys Inc. announced its fifth 510(k) clearance from the U.S.
NIH Issues $2.2 Million Grant for Augmented Reality Cardiac Hologram Research
News | Advanced Visualization | February 15, 2018
February 15, 2018 — The National Institutes of Health (NIH) awarded a $2.2 million research grant to healthcare techn
Patients Lack Information About Imaging Exams
News | Patient Engagement | February 14, 2018
Patients and their caregivers desire information about upcoming imaging examinations, but many are not getting it,...
Planmed Launches Improved Planmed Verity CBCT Scanner
Technology | Computed Tomography (CT) | February 07, 2018
Planmed announced the launch of the improved Planmed Verity cone beam computed tomography (CBCT) scanner for orthopedic...
PSMA PET-CT Clearly Differentiates Prostate Cancer from Benign Tissue

68Ga-PSMA PET/CT images showing multifocal PCA in peripheral zone with GS of 5 1 5 5 10. (A and C) Axial PET images. (B and D) Fused PET/CT images. SUVmax of lesion in B was 84.3 and that of lesion in D was 5.7. IRS was 3, and 80% of cells were stained. Credit: Senior author V Prasad, Charité Universitätsmedizin Berlin, Berlin, Germany.

News | PET-CT | February 05, 2018
February 5, 2018 — Using nuclear medicine...
MedyMatch Receives FDA Device Designation for Intracranial Hemorrhage Software
News | Computed Tomography (CT) | February 01, 2018
February 1, 2018 – MedyMatch Technology, a company focused on helping physicians provide accurate patient assessment
New Policy Decisions Give Millions Access to HeartFlow FFRct Analysis
News | Cardiac Imaging | February 01, 2018
February 1, 2018 – HeartFlow announced that seven new commercial payers issued positive medical policies covering the
Machine Learning Techniques Generate Clinical Labels of Medical Scans
News | Artificial Intelligence | January 31, 2018
Researchers used machine learning techniques, including natural language processing algorithms, to identify clinical...
Overlay Init