Using FFRct Analysis with Coronary CT to Improve Diagnosis and Reduce Unnecessary Invasive Angiography in Adults with Stable Chest Pain

What this Trial Is About

This research aims to evaluate the addition of Fractional Flow Reserve from coronary computed tomography FFRct in the diagnostic pathway for patients with stable chest pain, a common symptom of coronary artery disease CAD. The study focuses on patients whose initial Coronary Computed Tomography Angiography CCTA shows significant narrowing of the coronary arteries. Since CCTA alone sometimes leads to unnecessary invasive coronary angiography ICA, the study investigates whether adding FFRct can better identify hemodynamically significant stenoses and reduce unneeded invasive procedures. Participants are randomly assigned to one of two groups. One group receives the standard care, typically involving invasive coronary angiography after CCTA. The other group receives an FFRct analysis based on their CCTA images, which is a non-invasive software method that helps assess the functional significance of artery narrowing. If FFRct shows no significant narrowing, invasive angiography may be avoided. Treatment plans are reviewed and personalized by physicians. The study compares outcomes between these two diagnostic approaches. During the study, participants undergo initial CCTA and then the assigned diagnostic approach. Researchers will monitor the rate of unnecessary invasive coronary angiographies within 90 days as the primary outcome. Additional measures include rates of major cardiac events, need for further tests or revascularizations, quality of life assessments, and cost-effectiveness at both 90 days and one year. Follow-up and adherence to the diagnostic pathway are carefully tracked to assess the impact of adding FFRct to routine care.

Addition of FFRct in the Diagnostic Pathway of Patients With Stable Chest Pain