Aims The aim of this study was to evaluate the association between coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) and recurrent chest pain (CP) at 1-year follow-up in patients with stable angina pectoris (SAP). Methods and results Study of patients (n = 267) with SAP who underwent CCTA and FFRCT testing; 236 (88%) underwent invasive coronary angiography; and 87 (33%) were revascularized. Symptomatic status at 1-year follow-up was gathered by a structured interview. Three different FFRCT algorithms were applied using the following criteria for abnormality: (i) 2 cm-FFRCT ≤0.80; (ii) d-FFRCT ≤0.80; and (iii) a combination in which both a d-FFRCT ≤0.80 and a ΔFFRCT ≥0.06 must be present in the same vessel (c-FFRCT). Patients were classified into two groups based on the FFRCT test result and revascularization: completely revascularized/normal (CRN), patients in whom all coronary arteries with an abnormal FFRCT test result were revascularized or patients with completely normal FFRCT test results, and incompletely revascularized (IR), patients in whom ≥1 coronary artery with an abnormal FFRCT test result was not revascularized. Recurrent CP was present in 62 (23%) patients. Classification of patients (CRN or IR) was significantly associated with recurrent CP for all applied FFRCT interpretation algorithms. When applying the c-FFRCT algorithm, the association with recurrent CP was found, irrespective of the extent of coronary calcification and the degree of coronary stenosis. A negative association between per-patient minimal d-FFRCT and recurrent CP was demonstrated, P < 0.005. Conclusion An abnormal FFRCT test result is associated with an increased risk of recurrent CP in patients with new-onset SAP.

中文翻译：

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冠状动脉 CT 血管造影衍生的血流储备分数不稳定型心绞痛：与复发性胸痛的相关性


目的 本研究的目的是评估稳定型心绞痛 (SAP) 患者 1 年随访时冠状动脉计算机断层扫描血管造影 (CCTA) 衍生的血流储备分数 (FFRCT) 与复发性胸痛 (CP) 之间的关联。方法和结果 对接受 CCTA 和 FFRCT 测试的 SAP 患者 (n = 267) 进行研究； 236 例（88%）接受了侵入性冠状动脉造影； 87 例（33%）接受了血运重建。通过结构化访谈收集一年随访时的症状状况。应用三种不同的 FFRCT 算法，使用以下异常标准：(i) 2 cm-FFRCT ≤0.80； (ii) d-FFRCT ≤0.80； (iii) d-FFRCT ≤0.80 和 ΔFFRCT ≥0.06 必须同时存在于同一容器中的组合 (c-FFRCT)。根据FFRCT测试结果和血运重建将患者分为两组：完全血运重建/正常（CRN）、FFRCT测试结果异常的所有冠状动脉均进行了血运重建的患者或FFRCT测试结果完全正常且血运重建不完全的患者（ IR），其中 ≥1 条冠状动脉 FFRCT 测试结果异常未进行血运重建的患者。 62 名 (23%) 患者出现复发性 CP。对于所有应用的 FFRCT 解释算法，患者分类（CRN 或 IR）与复发性 CP 显着相关。当应用 c-FFRCT 算法时，发现与复发性 CP 相关，无论冠状动脉钙化程度和冠状动脉狭窄程度如何。每位患者的最小 d-FFRCT 与复发性 CP 之间存在负相关关系，P < 0.005。结论 FFRCT 检测结果异常与新发 SAP 患者复发 CP 的风险增加相关。