| Title: |
Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4) |
| Authors: |
Ghobrial, Mina; Haley, Hazel; Gosling, Rebecca; Taylor, Daniel James; Richardson, James; Morgan, Kenneth; Barmby, David; Iqbal, Javaid; Krishnamurthy, Arvindra; Singh, Rajender; Conway, Dwayne; Hall, Ian; Adam, Zulfiquar; Wheeldon, Nigel; Grech, Ever D; Storey, Robert F; Rothman, Alexander; Payne, Gillian; Tahir, Muhammad Naeem; Smith, Simon; Cooke, Justin; Hunter, Steven; Cartwright, Neil; Sadeque, Syed; Briffa, Norman Paul; Al-Mohammad, Abdallah; O’Toole, Laurence; Rogers, Dominic; Lawford, Patricia V; Hose, David R; Gunn, Julian; Morris, Paul D |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2024 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Coronary artery disease |
| Description: |
Background The practical application of ‘virtual’ (computed) fractional flow reserve (vFFR) based on invasive coronary angiogram (ICA) images is unknown. The objective of this cohort study was to investigate the potential of vFFR to guide the management of unselected patients undergoing ICA. The hypothesis was that it changes management in >10% of cases. Methods vFFR was computed using the Sheffield VIRTUheart system, at five hospitals in the North of England, on ‘all-comers’ undergoing ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The cardiologists’ management plan (optimal medical therapy, percutaneous coronary intervention (PCI), coronary artery bypass surgery or ‘more information required’) and confidence level were recorded after ICA, and again after vFFR disclosure. Results 517 patients were screened; 320 were recruited: 208 with ACS and 112 with CCS. The median vFFR was 0.82 (0.70–0.91). vFFR disclosure did not change the mean number of significantly stenosed vessels per patient (1.16 (±0.96) visually and 1.18 (±0.92) with vFFR (p=0.79)). A change in intended management following vFFR disclosure occurred in 22% of all patients; in the ACS cohort, there was a 62% increase in the number planned for medical management, and in the CCS cohort, there was a 31% increase in the number planned for PCI. In all patients, vFFR disclosure increased physician confidence from 8 of 10 (7.33–9) to 9 of 10 (8–10) (p |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://heart.bmj.com/cgi/content/short/110/16/1048; http://dx.doi.org/10.1136/heartjnl-2024-324039 |
| DOI: |
10.1136/heartjnl-2024-324039 |
| Availability: |
http://heart.bmj.com/cgi/content/short/110/16/1048; https://doi.org/10.1136/heartjnl-2024-324039 |
| Rights: |
Copyright (C) 2024, BMJ Publishing Group Ltd |
| Accession Number: |
edsbas.AE8A89FC |
| Database: |
BASE |